Risk factors for pneumocystis pneumonia in giant cell arteritis: a single-centre cohort study

Clin Exp Rheumatol. 2015 Mar-Apr;33(2 Suppl 89):S-122-5. Epub 2015 May 26.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / adverse effects*
  • Cohort Studies
  • Female
  • Giant Cell Arteritis / drug therapy*
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects*
  • Lymphopenia / chemically induced*
  • Lymphopenia / immunology
  • Male
  • Methotrexate / adverse effects*
  • Middle Aged
  • Pneumonia, Pneumocystis / chemically induced*
  • Pneumonia, Pneumocystis / immunology
  • Prednisone / adverse effects*
  • Prospective Studies

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Prednisone
  • Methotrexate