Reactions 1704, p126 - 2 Jun 2018
Pneumocystis pneumonia: 30 case reports
In a retrospective study, 30 patients aged between
93 years (21 women and nine men) were described, who
developed pneumocystis pneumonia (PCP) following
treatment with prednisone and cyclophosphamide [routes not
stated; not all dosages and outcomes stated].
The patients had been diagnosed with autoimmune diseases
like systemic lupus erythematosus, granulomatosis with
polyangiitis, rheumatoid arthritis, microscopic polyangiitis,
systemic sclerosis, dermatomyositis, temporal arteritis,
cryoglobulinaemic vasculitis or Sjogren syndrome.
Subsequently, the patients started receiving treatment with
prednisone and some patients received cyclophosphamide
pulse along with prednisone. The patients developed PCP
within 0.9 to 10.8 months. Only one patient had received
prophylaxis with cotrimoxazole, which was discontinued
prematurely due to unspecified adverse drug reaction.
Amongst the 30 patients, 11 patients died due to
Author comment: "The most important risk factor for PCP
in non-HIV patients is the use of immunosuppressive drugs,
especially corticosteroids." "[C]oncomitant cyclophosphamide
pulse and baseline lymphopenia were associated with an
increased incidence of PCP."
Park JW, et al. Prophylactic effect of trimethoprim-sulfamethoxazole for
pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged
high-dose glucocorticoids. Annals of the Rheumatic Diseases 77: 644-649, No. 5,
May 2018. Available from: URL: http://doi.org/10.1136/annrheumdis-2017-211796
- South Korea
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved