巨细胞动脉炎患者发生肺孢子菌肺炎的危险因素：一项单中心队列研究。
Risk factors for pneumocystis pneumonia in giant cell arteritis: a single-centre cohort study.
作者信息
Berger C T, Greiff V, John S, Koenig K F, Bigler M B, Recher M, Hess C, Daikeler T
机构信息
Medical Outpatient Clinic, Department of Internal Medicine, and Translational Immunology, Department of Biomedicine, University Hospital Basel, Switzerland.
Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
出版信息
Clin Exp Rheumatol. 2015 Mar-Apr;33(2 Suppl 89):S-122-5. Epub 2015 May 26.
OBJECTIVES
Pneumocystis jiroveci pneumonia (PCP) is a life-threatening opportunistic infection. Few PCP cases in giant cell arteritis (GCA) have been described, but it remains unknown, which patients need PCP prophylaxis.
METHODS
Sixty-two patients with GCA from a prospective cohort were studied to identify treatment-related predictors of PCP infection.
RESULTS
Four PCP infections occurred, all in patients treated with methotrexate in addition to prednisone. Moreover, PCP is associated with higher cumulative PDN doses and severe lymphocytopenia (<400/μl).
CONCLUSIONS
Our findings support PCP-prophylaxis in GCA patients who are treated with methotrexate and PDN, and need high prednisone doses to achieve remission, or develop severe lymphocytopenia.
目的
耶氏肺孢子菌肺炎（PCP）是一种危及生命的机会性感染。巨细胞动脉炎（GCA）中PCP病例鲜有报道，但哪些患者需要预防PCP仍不清楚。
方法
对前瞻性队列中的62例GCA患者进行研究，以确定PCP感染的治疗相关预测因素。
结果
发生了4例PCP感染，均为除泼尼松外还接受甲氨蝶呤治疗的患者。此外，PCP与更高的累积泼尼松剂量和严重淋巴细胞减少（<400/μl）相关。
结论
我们的研究结果支持对接受甲氨蝶呤和泼尼松治疗、需要高剂量泼尼松以实现缓解或出现严重淋巴细胞减少的GCA患者进行PCP预防。
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