Objectives To elucidate the decrease ratio of lymphocyte counts as a contributing risk factor for Pneunocystis pneumonia (PCP) in immunocompromised hosts.
Methods Twenty patients with PCP who received prednisolone (PSL), DMARDs or Biologics were enrolled from September 1984 to February 2013 in our hospital. Patient were classified as follows:
Group 1: received only PSL (mean PSL: 27.0±5.4 mg/day) (n=13).
Group 2: received PSL with DMARDs or Biologics (mean PSL: 8.4±2.9 mg/day) (n=7).
Control group: non-PCP patients received only PSL without PCP prophylaxis (mean PSL: 16.5±2.5 mg/day) (n=13).
Statististically, there is no significant differences about the doseage of PSL between Group1 and control group (p=0.36).The decrease ratio of the lymphocyte counts between just before receiving the immunosuppressants and at the onset of PSP (ΔLym) were calculated in each group.
Results Primary diseases were CTD (n=14), non-CTD (n=6) in Group 1 and 2. CTD (n=13) were selected as a control group. Mean ΔLym in Group 1, 2 and Control group were 80.5±4.3%, 62.6±4.2% and 33.5%±8.0%, respectively. The mean ΔLym in Group1 was significantly decreased compared with those of in control group (80.5% vs 33.5%: p<0.0001). In ROC analysis, the cut-off value of ΔLym for was 60.9% (sensitivity: 92.3%, specificity: 92.3%, odds ratio: 144.0).
Conclusions ΔLym might be a new risk factor and an index parameter for the indication for prophylaxis of PCP.
Disclosure of Interest None declared
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