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THU0441 Potential Fatality Predictors Caused by Pneumocystis Pneumonia (PCP) in Rheumatic Disease
  1. R. Yanai1,
  2. S. Isojima1,
  3. H. Tsukamoto1,
  4. T. Tokunaga1,
  5. M. Umemura1,
  6. H. Furuya1,
  7. K. Otsuka1,
  8. R. Takahashi1,
  9. K. Wakabayashi1,
  10. N. Yajima1,
  11. Y. Miwa1,
  12. T. Kasama1
  1. 1Division of Rheumatology, Department of Medicine, Showa University, School Of Medicine, Tokyo, Japan

Abstract

Background Complications of pneumocystis pneumonia (PCP) are one of the predictors of fatality in rheumatic disease. Although clinical characteristics and risk factors for PCP in rheumatic diseases have been studied, there have been no reports of poor prognosis factor of the PCP.

Objectives We examined the poor prognosis factors caused by PCP in rheumatic disease at admission.

Methods From 2010 to 2012, 28 patients with rheumatic diseases and coexisting PCP were examined retrospectively (rheumatoid arthritis, 19 patients; systemic lupus erythematosus, 2 patients; systemic sclerosis, 2 patients; microscopic polyangiitis, 2 patients; relapsing polychondritis, 1 patient; pseudogout, 1 patient; autoimmune hepatitis, 1 patient). We divided the patients into two groups: surviving patients (group A; n=23) and deceased patients (group B; n=5). Age, sex, smoking history, past history of pulmonary disease, hospitalization and prednisolone dosage were examined. The following were also recorded at admission: white blood cell count, lymphocyte count, arterial blood gas PaO2/FIO2 ratio, serum creatinine level with estimated glomerular filtration rate (eGFR), and the levels of hemoglobin, lactase dehydrogenase(LDH), albumin, C-reactive protein (CRP), β-D-glucan, Krebs von den Lungen-6 (KL-6), pulmonary surfactant-D (SP-D), IgG, and IgA.

Results The results were as follows:

Conclusions Either higher age, high serum creatinine levels and CRP or low serum albumin levels, IgA and PaO2/FIO2 ratio are potential fatality predictors following admission caused by PCP in patients with rheumatic disease.

Disclosure of Interest None Declared

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