2007
DOI: 10.1111/j.1445-5994.2007.01382.x
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Abstract: In our study the annual incidence of PCP in patients taking MTX was low and would not support the use of routine PCP chemoprophylaxis. In patients receiving CYC without concomitant PCP chemoprophylaxis the annual incidence of PCP was higher although the number of cases was small. Given the high morbidity and mortality in this group, PCP chemoprophylaxis should be considered.

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Cited by 15 publications
(15 citation statements)
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“…Hormone therapy is the uppermost risk factor; >90% of patients who present with fungal infection involvement PCP have received long-term hormone therapy (23). If elderly patients, patients with nutritional deficiency or patients with low-lymphocytes lipoproteinaemia receive >16 mg/d equivalent hormone (>2 months) or >20 mg/d (>1-month) hormone therapy, the risk of PCP infection markedly increases (24).…”
Section: Discussionmentioning
confidence: 99%
“…Hormone therapy is the uppermost risk factor; >90% of patients who present with fungal infection involvement PCP have received long-term hormone therapy (23). If elderly patients, patients with nutritional deficiency or patients with low-lymphocytes lipoproteinaemia receive >16 mg/d equivalent hormone (>2 months) or >20 mg/d (>1-month) hormone therapy, the risk of PCP infection markedly increases (24).…”
Section: Discussionmentioning
confidence: 99%
“…One set of recommendations has suggested that any patient on greater than 20 mg of prednisone per day for over one month (in adults) or greater than 2 mg/kg per day for two weeks for children should be considered high risk 19, 36, 37. In addition, Wegener granulomatosis and polymyositis/dermatomyositis are thought to have particularly increased susceptibility to PCP 28, 38, 39. These diseases are rare in children and specific guidelines for prophylaxis in children with autoimmune disease have not been developed.…”
Section: Discussionmentioning
confidence: 99%
“…19,36,37 In addition, Wegener granulomatosis and polymyositis/dermatomyositis are thought to have particularly increased susceptibility to PCP. 28,38,39 These diseases are rare in children and specific guidelines for prophylaxis in children with autoimmune disease have not been developed. We specifically sought for evidence that the newer biologic agents might be associated with PCP and none of the patients were on TNF inhibitors or other biologic agents.…”
Section: Discussionmentioning
confidence: 99%
“…Previously proposed risk factors for PCP in patients with connective tissue disease already susceptible to opportunistic infection from immunosuppressive medication include use of systemic corticosteroids, 2,3,23,24 particularly with a daily prednisone dose of 16 mg or higher for 8 weeks or longer 3 ; cytotoxic agents (cyclophosphamide 2,8 more than methotrexate 2,8,23 ); lack of PCP prophylaxis 23 ; advanced age 4 ; high degree of disease activity 24 ; pulmonary disease, 4,16 such as interstitial pulmonary fibrosis 16,25 ; leukopenia 2,24,26 ; CD4 1 lymphocyte counts less than 0.3 3 10 9 /L 24,26 ; and hypoalbuminemia. 27 The patient in our study in whom PCP developed (in her 10th decade of life, not on PCP prophylaxis, and with severe pulmonary fibrosis and hypoalbuminemia) had at least 4 risk factors for PCP in addition to iatrogenic immunosuppression with prednisone (Table IV).…”
Section: Discussion Pcp Immunosuppressive Medications and Dermatolomentioning
confidence: 99%
“…Iatrogenic immunosuppression may predispose certain patients to infection with opportunistic microorganisms, such as Pneumocystis jiroveci (formerly P carinii), which can cause potentially lifethreatening pneumonia. 1 Although systemic corticosteroid use has been most closely linked with the development of pneumocystis pneumonia (PCP), 2,3 this opportunistic infection has also been associated with other immunosuppressive medications used commonly in dermatology, such as infliximab, 4 methotrexate, 5 azathioprine, 6 cyclosporine, 7 cyclophosphamide, 8 and adalimumab. 9 Whether mycophenolate mofetil predisposes patients to PCP 10 or protects them from it 11 is unclear.…”
mentioning
confidence: 99%