Atsushi Yoshida1, Noriko Kamata2, Akihiro Yamada3, Yoko Yokoyama4, Teppei Omori5, Toshimitsu Fujii6, Ryohei Hayashi7, Tetsu Kinjo8, Akira Matsui9, Norimasa Fukata10, Sakuma Takahashi11, Ryosuke Sakemi12, Noriyuki Ogata13, Shinya Ashizuka14, Shigeki Bamba15, Makoto Ooi16, Shuji Kanmura17, Katsuya Endo18, Takuya Yoshino19, Hiroki Tanaka20, Toshio Morizane1, Shinichiro Shinzaki21, Taku Kobayashi22. 1. Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Kamakura, Japan. 2. Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan. 3. Department of Internal Medicine, Sakura Medical Center, Toho University, Tokyo, Japan. 4. Department of Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. 5. Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 6. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan. 7. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan. 8. Department of Endoscopy, University of the Ryukyus Hospital, Nishihara, Japan. 9. Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. 10. Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Japan. 11. Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan. 12. Department of Gastroenterology, Tobata Kyoritsu Hospital, Kitakyushu, Japan. 13. Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. 14. Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. 15. Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Japan. 16. Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 17. Department of Endoscopy, Kagoshima University Hospital, Kagoshima, Japan. 18. Department of Gastroenterology, Tohoku Medical and Pharmaceutical University, Sendai, Japan. 19. Division of Inflammatory Bowel Disease, Digestive Disease Center, Kitano Hospital, Osaka, Japan. 20. IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan. 21. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan. 22. Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) is highly fatal once infection is established. In this study, we investigated the risk of PJP mortality in patients with inflammatory bowel disease (IBD). METHODS: We conducted a retrospective observational study of case data from IBD patients who developed PJP, compiled from 17 collaborating institutions. Parameters such as age, sex, medications used, and blood test results were analyzed to identify risk factors for mortality. RESULTS: The mortality rate among the 28 IBD patients who developed PJP was 17.9%. A low serum albumin level at the start of IBD treatment was identified as a risk factor for mortality and showed the following association with probability of death (P): P = 1/[1 + exp(-5.5 + 2.4 × Alb). The probability of death exceeded 0.5 when serum albumin was 2.2 g/dL or lower. CONCLUSION: Patients with IBD who develop PJP have a high mortality rate and often cannot continue treatment with medication alone. Therefore, it is necessary to pay attention to albumin levels at the start of immunosuppressive therapy when creating a treatment plan.
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) is highly fatal once infection is established. In this study, we investigated the risk of PJP mortality in patients with inflammatory bowel disease (IBD). METHODS: We conducted a retrospective observational study of case data from IBD patients who developed PJP, compiled from 17 collaborating institutions. Parameters such as age, sex, medications used, and blood test results were analyzed to identify risk factors for mortality. RESULTS: The mortality rate among the 28 IBD patients who developed PJP was 17.9%. A low serum albumin level at the start of IBD treatment was identified as a risk factor for mortality and showed the following association with probability of death (P): P = 1/[1 + exp(-5.5 + 2.4 × Alb). The probability of death exceeded 0.5 when serum albumin was 2.2 g/dL or lower. CONCLUSION: Patients with IBD who develop PJP have a high mortality rate and often cannot continue treatment with medication alone. Therefore, it is necessary to pay attention to albumin levels at the start of immunosuppressive therapy when creating a treatment plan.
Authors: Peter D Walzer; Hannah E R Evans; Andrew J Copas; Simon G Edwards; Alison D Grant; Robert F Miller Journal: Clin Infect Dis Date: 2008-02-15 Impact factor: 9.079
Authors: Joris Arts; Geert D'Haens; Miranda Zeegers; Gert Van Assche; Martin Hiele; André D'Hoore; Freddy Penninckx; Severine Vermeire; Paul Rutgeerts Journal: Inflamm Bowel Dis Date: 2004-03 Impact factor: 5.325
Authors: J F Rahier; S Ben-Horin; Y Chowers; C Conlon; P De Munter; G D'Haens; E Domènech; R Eliakim; A Eser; J Frater; M Gassull; M Giladi; A Kaser; M Lémann; T Moreels; A Moschen; R Pollok; W Reinisch; M Schunter; E F Stange; H Tilg; G Van Assche; N Viget; B Vucelic; A Walsh; G Weiss; Y Yazdanpanah; Y Zabana; S P L Travis; J F Colombel Journal: J Crohns Colitis Date: 2009-04-26 Impact factor: 9.071