P114 Risk factors and clinical characteristics for
Pneumocystis jirovecii pneumonia in Japanese patients with ulcerative colitis
T. Sato1, R. Koshiba*1, K. Kojima1, K. Fujimoto1, M. Kawai1, K. Kamikoduru1, Y. Yokoyama1, T. Takagawa1, M. Uchino2, N. Hida1, K. Watanabe1, H. Miwa3, H. Ikeuchi2, S. Nakamura1
1Hyogo College of Medicine, Division of Internal Medicine, Department of Inflammatory Bowel Disease, Nisinomiya, Hyogo, Japan, 2Hyogo College of Medicine, Division of Surgery, Department of Inflammatory Bowel Disease, Nisinomiya, Hyogo, Japan, 3Hyogo College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Nisinomiya, Hyogo, Japan
Of the 3927 patients with UC between April 2007 and March 2017 received immunosuppressive drugs. Seventy patients experienced pneumonia, including nine patients with NH-PJP. A retrospective case–control study was conducted in these patients, with an NH-PJP group (
Two patients in the NH-PJP group died. The median LCI (range) at the initiation of treatment was 13 (8–17), whereas that at NH-PJP onset was 2 (1–8) (
Comparison of Lichtiger clinical activity index before treatment and at the onset of PJP. Median score 13 (range 8–17) before treatment decreased significantly to 2 (1–8) at the onset of PCP. *Wilcoxon’s signed-rank test.
The median period to NH-PJP onset was 83 days from the beginning of immunosuppressive treatment. Age and the dose of prednisolone (PSL; mg/day) were significantly greater (
NH-PJP occurred when the symptoms of UC were stabilising, when the immunosuppressive drugs were reduced. Senior age, a higher dose of PSL (mg/day), and lower lymphocyte counts during treatment are risk factors for NH-PJP. Prophylactic treatment with TPM-SMX should be used for UC patients with these risk factors.
1. Thomas CF Jr, Limper AH. Pneumocystis pneumonia: clinical presentation and diagnosis in patients with and without acquired immune deficiency syndrome.
2. Sato T, Inokuma S, Maezawa R. Clinical characteristics of
3. Iikuni N, Kitahama M, Ohta S,
4. Rahier JF, Magro F, Abreu C,