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Prevalence, Risk Factors, and Mortality of Invasive Pulmonary Aspergillosis in Patients with Anti-MDA5+ Dermatomyositis: A Retrospective Study in China

التفاصيل البيبلوغرافية
العنوان: Prevalence, Risk Factors, and Mortality of Invasive Pulmonary Aspergillosis in Patients with Anti-MDA5+ Dermatomyositis: A Retrospective Study in China
المؤلفون: Chen X, Lin S, Jin Q, Zhang L, Jiang W, Lu X, Wang G, Ge Y
المصدر: Journal of Inflammation Research, Vol Volume 17, Pp 3247-3257 (2024)
بيانات النشر: Dove Medical Press, 2024.
سنة النشر: 2024
المجموعة: LCC:Pathology
LCC:Therapeutics. Pharmacology
مصطلحات موضوعية: invasive pulmonary aspergillosis, opportunistic infection, anti-mda5+ dermatomyositis, prevalence, risk factors, prognosis, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
الوصف: Xixia Chen,1 Sang Lin,2 Qiwen Jin,1 Lu Zhang,3 Wei Jiang,3 Xin Lu,3 Guochun Wang,1,3 Yongpeng Ge3 1Peking University China-Japan Friendship School of Clinical Medicine, Beijing, People’s Republic of China; 2Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Rheumatology, Key Myositis Laboratories, China-Japan Friendship Hospital, Beijing, People’s Republic of ChinaCorrespondence: Yongpeng Ge, Department of Rheumatology, China-Japan Friendship Hospital, Yinghua East Road, Chaoyang District, Beijing, 100029, People’s Republic of China, Tel +86 13716106183, Email gyp2016@163.comObjective: To investigate the prevalence, risk factors and prognosis of invasive pulmonary aspergillosis (IPA) in patients with anti-melanoma differentiation-associated gene 5 positive dermatomyositis (anti-MDA5+ DM).Methods: A retrospective analysis was conducted in anti-MDA5+ DM patients diagnosed between January 2016 and March 2023. Patients with lower respiratory tract specimens were categorized into IPA+ and IPA- groups based on the presence of IPA and their clinical characteristics and prognoses then compared.Results: Of the 415 patients diagnosed with anti-MDA5+ DM, 28 cases had IPA (prevalence rate of 6.7%) with Aspergillus fumigatus being the most common species. The patients were categorized into IPA+ (n=28) and IPA- (n=98) groups, with no significant age or gender-related differences (P> 0.05). The IPA+ group had a lower lymphocyte count, particularly the CD4+ T-cell count, and reduced serum albumin and higher serum ferritin levels (P all< 0.05). An elevated bronchoalveolar lavage fluid (BALF) galactomannan level was found to be the sole independent risk factor for the occurrence of IPA (adjusted OR=2.191, P=0.029) with a cut-off value of 0.585 and area under the curve of 0.779. The mortality rate in the IPA+ group was 25%. Compared to survivors, non-survivors in this group exhibited a higher incidence of rapidly progressive interstitial lung disease, lower lymphocyte counts, and increased co-infection with Pneumocystis jirovecii (P all< 0.05).Conclusion: IPA was not rare in patients with anti-MDA5+ DM, with elevated BALF galactomannan levels being an independent risk factor for IPA occurrence. Clinicians must exercise vigilance to identify patients exhibiting the aforementioned risk factors.Keywords: invasive pulmonary aspergillosis, opportunistic infection, anti-MDA5+ dermatomyositis, prevalence, risk factors, prognosis
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1178-7031
Relation: https://www.dovepress.com/prevalence-risk-factors-and-mortality-of-invasive-pulmonary-aspergillo-peer-reviewed-fulltext-article-JIR; https://doaj.org/toc/1178-7031
URL الوصول: https://doaj.org/article/6e175016694d4c5f8c111811f204c438
رقم الأكسشن: edsdoj.6e175016694d4c5f8c111811f204c438
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:11787031