Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease–a Case Series
| العنوان: | Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease–a Case Series |
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| المؤلفون: | Vieujean, S, Moens, A, Hassid, D, Rothfuss, K, Savarino, E, Vavricka, S R, Reenaers, C, Jacobsen, B, Allez, M, Ferrante, M, Rahier, Jean-François, ECCO CONFER investigators |
| المساهمون: | UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de gastro-entérologie |
| المصدر: | Vieujean, S, Moens, A, Hassid, D, Rothfuss, K, Savarino, E V, Vavricka, S R, Reenaers, C, Jacobsen, B A, Allez, M, Ferrante, M, Rahier, J-F & ECCO CONFER investigators 2023, ' Pneumocystis jirovecii pneumonia in patients with inflammatory bowel disease-A case series ', Journal of Crohn's & colitis, vol. 17, no. 4, jjac153, pp. 472–479 . https://doi.org/10.1093/ecco-jcc/jjac153 Journal of Crohn's & colitis, Vol. 17, no. 4, p. 472-479 (2022) |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | inflammatory bowel disease, Gastroenterology, General Medicine, Pneumocystis jirovecii pneumonia |
| الوصف: | Background and aim: Pneumocystis jirovecii pneumonia [PJP] is a very rare, potentially life-threatening pulmonary fungal infection that occurs in immunocompromised individuals including patients with inflammatory bowel disease [IBD]. Our aim was to describe immunosuppressive treatment exposure as well as the outcome in IBD patients with PJP.Methods: PJP cases were retrospectively collected through the COllaborative Network For Exceptionally Rare case reports of the European Crohn's and Colitis Organisation. Clinical data were provided through a case report form.Results: In all, 18 PJP episodes were reported in 17 IBD patients [10 ulcerative colitis and seven Crohn's disease]. The median age at PJP diagnosis was 55 years (interquartile range [IQR], 40-68 years]. Two PJP [11.1%] occurred in patients on triple immunosuppression, 10 patients [55.6%] had double immunosuppressive treatment, four patients [22.2%] had monotherapy and two PJP occurred in absence of immunosuppressive treatment [one in a human immunodeficiency virus patient and one in a patient with a history of autologous stem cell transplantation]. Immunosuppressive therapies included steroids [n = 12], thiopurines [n = 10], infliximab [n = 4], ciclosporin [n = 2], methotrexate [n = 1], and tacrolimus [n = 1]. None of the patients diagnosed with PJP had received prophylaxis. All patients were treated by trimethoprim/sulphamethoxazole or atovaquone and an intensive care unit [ICU] stay was required in seven cases. Two patients [aged 71 and 32 years] died, and one patient had a recurrent episode 16 months after initial treatment. Evolution was favourable for the others.Conclusion: This case series reporting potentially fatal PJP highlights the need for adjusted prophylactic therapy in patients with IBD on immunosuppressive therapy. Background and aim: Pneumocystis jirovecii pneumonia [PJP] is a very rare, potentially life-threatening pulmonary fungal infection that occurs in immunocompromised individuals including patients with inflammatory bowel disease [IBD]. Our aim was to describe immunosuppressive treatment exposure as well as the outcome in IBD patients with PJP.Methods: PJP cases were retrospectively collected through the COllaborative Network For Exceptionally Rare case reports of the European Crohn's and Colitis Organisation. Clinical data were provided through a case report form.Results: In all, 18 PJP episodes were reported in 17 IBD patients [10 ulcerative colitis and seven Crohn's disease]. The median age at PJP diagnosis was 55 years (interquartile range [IQR], 40-68 years]. Two PJP [11.1%] occurred in patients on triple immunosuppression, 10 patients [55.6%] had double immunosuppressive treatment, four patients [22.2%] had monotherapy and two PJP occurred in absence of immunosuppressive treatment [one in a human immunodeficiency virus patient and one in a patient with a history of autologous stem cell transplantation]. Immunosuppressive therapies included steroids [n = 12], thiopurines [n = 10], infliximab [n = 4], ciclosporin [n = 2], methotrexate [n = 1], and tacrolimus [n = 1]. None of the patients diagnosed with PJP had received prophylaxis. All patients were treated by trimethoprim/sulphamethoxazole or atovaquone and an intensive care unit [ICU] stay was required in seven cases. Two patients [aged 71 and 32 years] died, and one patient had a recurrent episode 16 months after initial treatment. Evolution was favourable for the others.Conclusion: This case series reporting potentially fatal PJP highlights the need for adjusted prophylactic therapy in patients with IBD on immunosuppressive therapy. |
| تدمد: | 1876-4479 1873-9946 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d01a5621211fbb04e37c65985668ee5 https://doi.org/10.1093/ecco-jcc/jjac153 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....7d01a5621211fbb04e37c65985668ee5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18764479 18739946 |
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