[Pneumocystis jiroveci pneumonia as a complication of glucocorticoid therapy for interstitial pneumonia].
We evaluated the clinical features of pneumocystis jiroveci pneumonia (PCP) as a complication of glucocorticoid therapy for interstitial pneumonia We analyzed 74 interstitial pneumonia patients receiving glucocorticoid therapy, of whom 7 patients developed PCP. At the time of PCP diagnosis, the average duration of the glucocorticoid therapy was 71 days and the average daily dose of predonisolone was 37 mg. Circulating CD4+ lymphocyte counts were 370/microl on the average and more than 200/microl in three cases. PCP cases showed less circulating lymphocyte counts four weeks after the initiation of the therapy. Any cases receiving sulfamethoxazole-trimethoprim (TMP-SMX) did not develop PCP. In conclusion, interstitial pneumonia patients, who are treated with glucocorticoid, are benefit from TMP-SMX as PCP prophylaxis, but CD4 + lymphocyte counts greater than 200/microl is no reason to denying PCP.
Enomoto
Tatsuji
T
Department of Respiratory Medicine, Tokyo Metropolitan Hiroo General Hospital.
Azuma
Arata
A
Matsumoto
Aki
A
Nei
Takahito
T
Hiramatsu
Kumiko
K
Abe
Shinji
S
Usuki
Jiro
J
Kudoh
Shoji
S
D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000276:immunology / Q000517:prevention & control; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
D000890:Anti-Infective Agents; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011239:Prednisolone