Foster H E, Malleson P N, Petty R E, Roberton D M, Cabral D A
Department of Pediatrics, University of British Columbia, Vancouver, Canada.
J Rheumatol. 1996 Apr;23(4):753-6.
Although Pneumocystis carinii pneumonia (PCP) is known to occur in adults with systemic lupus erythematosus (SLE), this infection has rarely been described in childhood SLE. We describe 3 children with SLE who developed PCP and describe risk factors for this complication.
A retrospective case review.
All 3 children had severe active SLE with organ involvement requiring immunosuppressive therapy, but the clinical presentations of PCP differed in each patient. They shared some of the known risk factors for opportunistic infection in adults with SLE, including lymphopenia, but severe lymphopenia (< 0.35 x 10(9)/1) was not seen.
PCP is an uncommon but serious complication of childhood SLE, and should be considered in the presence of respiratory symptoms, however subtle. The role of oral chemoprophylaxis is discussed.
虽然已知卡氏肺孢子虫肺炎(PCP)发生于患有系统性红斑狼疮(SLE)的成人,但这种感染在儿童SLE中鲜有描述。我们报告3例发生PCP的儿童SLE患者,并描述该并发症的危险因素。
一项回顾性病例分析。
所有3例儿童均患有严重的活动性SLE,伴有器官受累,需要免疫抑制治疗,但每位患者PCP的临床表现有所不同。他们具有一些成人SLE患者机会性感染的已知危险因素,包括淋巴细胞减少,但未出现严重淋巴细胞减少(<0.35×10⁹/L)。
PCP是儿童SLE一种罕见但严重的并发症,无论症状多么轻微,出现呼吸道症状时均应考虑该病。文中讨论了口服化学预防的作用。