Prognostic impact of pre-existing interstitial lung disease in non-HIV patients with Pneumocystis pneumonia
| Autor: | Megumi Inaba, Naomi Hirata, Takuro Sakagami, Takeshi Yoshinaga, Kimitaka Akaike, Shohei Hamada, Hidenori Ichiyasu, Tomoki Sadamatsu, Aiko Masunaga, Yasumasa Tashiro, Hiroshi Takahashi |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment MEDLINE lcsh:Medicine Pneumocystis pneumonia behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine Internal medicine medicine In patient 030212 general & internal medicine Proportional hazards model business.industry Medical record Incidence (epidemiology) lcsh:R Interstitial lung disease Immunosuppression respiratory system medicine.disease respiratory tract diseases body regions 030228 respiratory system business |
| Zdroj: | ERJ Open Research, Vol 6, Iss 2 (2020) |
| ISSN: | 2312-0541 |
| DOI: | 10.1183/23120541.00306-2019 |
| Popis: | BackgroundThe increasing incidence of life-threatening Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients is a global concern. Yet, no reports have examined the prognostic significance of pre-existing interstitial lung disease (ILD) in non-HIV PCP.MethodsWe retrospectively reviewed the medical records of non-HIV PCP patients with (ILD group) or without (non-ILD group) pre-existing ILD. The clinical features and outcomes of the ILD group were compared with those of the non-ILD group. Cox regression models were constructed to identify prognostic factors.Results74 patients were enrolled in this study. The 90-day mortality was significantly higher in the ILD group than in the non-ILD group (62.5% versus 19.0%, pd-glucan were significantly reduced after treatment of PCP in both groups, whereas levels of Krebs von den Lungen-6 (KL-6) significantly increased in the ILD group. In the ILD group, the 90-day mortality of patients with increasing KL-6 levels after treatment was significantly higher than those with decreasing levels (78.9% versus 0%, p=0.019).ConclusionIn non-HIV PCP patients, pre-existing ILD is associated with a poorer prognosis. Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression. |
| Databáze: | OpenAIRE |
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