Pneumocystis Jirovecii Pneumonia Complicating Systemic Vasculitis Save
A retrospecitive analysis of 62 patients with systemic vasculitis complicated by Pneumocystis jirovecii pneumonia (PJP) showed those with microscopic polyangiitis (MPA) had a higher mortality risk, possibly due to a higher prevalence of interstitial lung disease (ILD) in MPA.
From a total of 62 vasculitis-PJP patients, 48 had anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), with microscopic polyangiitis (MPA) being the most common subtype (28 patients). Mortality was predicted by:
- MPA (HR 4.33, p = 0.001)
- concomitant aspergillosis (HR 2.68, p = 0.019)
- higher D-dimer at PJP diagnosis (HR 1.07, p = 0.004)
MPA patients were older (median 69 vs. 58 years, p = 0.001); and had more ILD (ILD: 78.6% vs. 35.3%, p = 0.001 and and fibrotic ILD (57.1% vs. 11.8%, p < 0.001).
The authors suggest greater attention to PJP prophylaxis in managing systemic vasculitis patients, especially those with ILD and/or MPA.
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The author has no conflicts of interest to disclose related to this subject
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