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AB0426 Risk of Pneumocystis Carinii Pneumonia Infection in Patients with Systemic Lupus Erythematosus: A Nationwide Population Cohort Study
  1. W.H. Wang1,
  2. C.-C. Lai2,
  3. Y.-S. Chang3
  1. 1Kuanshan Tzu Chi Hospital, Taitung
  2. 2Taipei Veterans General Hospital, Taipei City
  3. 3Shuang Ho Hospital, New Taipei City, Taiwan, Province of China

Abstract

Background Pneumocystis carinii pneumonia (PJP) infection often affects immunocompromised patients may cause severe morbidity and mortality. PJP may be preventable by prophylactic antibiotics in high risk patients. However, the epidemiology and risk factors for PJP in patients with systemic lupus erythematosus (SLE) are not full studied.

Objectives This nationwide population-based study aimed to evaluate the risk of PJP in patients with systemic lupus erythematosus in Taiwan.

Methods We identified 23,378 SLE patients from the National Health Insurance research database between 1997 and 2012 and compared the incidence rate (IR) of PJP infection with that of 93,512 age- and gender-matched non-SLE cohort. A Cox multivariable proportional hazards model was applied to evaluate the risk of PJP infection in the SLE cohort. Risk factors of PJP infection were also analyzed.

Results The SLE cohort had a significantly higher IR of PJP infection (SLE IR=2.49, control IR=0.10, incidence rate ratio = 26.06, p<0.001). Male (Hazard ratio [HR] = 2.05, p=0.039), end stage renal disease (HR=1.88, p=0.035), use of mycofenolate mofetil (HR=5.11, p<0.001), intravenous steroid pulse therapy (HR=96.23, p<0.001).

Table 1.

Risk factors of PJP infection in patients with SLE

Conclusions Higher risk of PJP infection was observed in SLE patients. Risk factors for PJP infection include male, end stage renal disease, use of mycofenolate mofetil, intravenous steroid pulse therapy and an oral daily steroid dose over 7.5mg.

  1. Ratchaya Lertnawapan, Kitti Totemchokchyakarn, Kanokrat Nantiruj, Suchela Janwityanujit. Risk factors of Pneumocystis jeroveci pneumonia in patients with systemic lupus erythematosus. Rheumatol Int 2009;29:491–496.

  2. Michael M. Ward, Fiona Donald. Pneumocystis carinii pneumonia in patients with connective tissue diseases. Arthritis & Rheumatism 1999;42:780–789.

  3. Chia-Tse Weng, Ming-Fei Liu, Meng-Yu Weng, et al. Pneumocystis jirovecii Pneumonia in Systemic Lupus Erythematosus From Southern Taiwan. J Clin Rheumatol. 2013;19:252–8.

Disclosure of Interest None declared

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