Kadoya A, Okada J, Iikuni Y, Kondo H
Department of Internal Medicine, Kitasato University School of Medicine, Japan.
J Rheumatol. 1996 Jul;23(7):1186-8.
To investigate risk factors for Pneumocystis carinii pneumonia (PCP) in patients with systemic lupus erythematosus (SLE) and polymyositis/dermatomyositis (PM/DM).
The subjects were 75 patients hospitalized because of SLE or PM/DM who were administered corticosteroids 40 mg/day or above as prednisolone. The relationship between clinical symptoms of SLE and PM/DM and the occurrence of PCP was evaluated.
Seven patients (9.3%) developed PCP and 3 died. Interstitial pulmonary fibrosis was observed in all 7 patients who developed PCP, and its incidence was significantly higher (p < 0.001) than in those who did not develop PCP (6/68). The incidence of PCP in patients with SLE was 1.7%, but that of patients with PM/DM was 37.5%. The peripheral blood lymphocyte count was 1052.7/microliters in patients who developed PCP, which was significantly lower (p < 0.01) than 1841.6/microliters in patients who did not develop PCP.
A low peripheral lymphocyte count and interstitial pulmonary fibrosis were considered risk factors for PCP in patients administered corticosteroids for SLE or PM/DM.
探讨系统性红斑狼疮（SLE）和多发性肌炎/皮肌炎（PM/DM）患者发生卡氏肺孢子虫肺炎（PCP）的危险因素。
研究对象为75例因SLE或PM/DM住院且接受相当于泼尼松龙40mg/天及以上剂量糖皮质激素治疗的患者。评估SLE和PM/DM的临床症状与PCP发生之间的关系。
7例患者（9.3%）发生PCP，3例死亡。所有发生PCP的7例患者均观察到间质性肺纤维化，其发生率显著高于未发生PCP的患者（6/68）（p<0.001）。SLE患者中PCP的发生率为1.7%，而PM/DM患者中为37.5%。发生PCP的患者外周血淋巴细胞计数为1052.7/微升，显著低于未发生PCP的患者（1841.6/微升）（p<0.01）。
外周淋巴细胞计数低和间质性肺纤维化被认为是接受糖皮质激素治疗的SLE或PM/DM患者发生PCP的危险因素。
