Severe infections in patients with autoimmune diseases treated with cyclophosphamide
Severe infections in patients with autoimmune diseases treated with cyclophosphamide
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DOI：
10.1016/j.reuma.2014.09.003
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发表时间：
2015-07-01
影响因子：
1.5
通讯作者：
Musuruana, Jorge L.
中科院分区：
文献类型：
--
作者：
Cavallasca, Javier A.;Costa, Cecilia A.;Musuruana, Jorge L.
前言：感染性疾病是结缔组织病患者发病和死亡的重要原因。皮质类固醇和免疫抑制剂，如环磷酰胺(CyC)，会增加感染的风险。本研究的目的是评估接受环磷酰胺治疗的患者严重感染的发生率。患者和方法：回顾60例接受环磷酰胺治疗的系统性自身免疫病患者的记录。结果：系统性红斑狼疮是最常见的疾病，弥漫性增生性肾小球肾炎是最常见的指征。严重感染9例(15%)。社区获得性肺炎最常见，3例(33%)，其次带状疱疹2例(22%)。累积皮质类固醇剂量是感染的唯一显著危险因素，分别为32.8±16.7和20.1+15.3，P=0.007。结论：在接受环磷酰胺治疗的患者中，使用较小剂量的皮质类固醇和积极处理感染并发症是可以接受的安全性。(C)2014 Elsevier Espafia，S.L.U。保留所有权利。
Introduction: Infectious diseases are a significant cause of morbidity and mortality in patients with connective tissue diseases. Corticosteroids and immunosuppressive drugs, such as cyclophosphamide (CYC), increases the risk of infections. The objective of this study was to estimate the incidence rates of severe infections in patients who received treatment with CYC.Patients and methods: The records of 60 patients with systemic autoimmune diseases who received treatment with CYC were retrospectively reviewed. We evaluated the rate of severe infections that occurred during CYC therapy and the 3 subsequent months.Results: Systemic lupus erythematosus was the most common disease, and diffuse proliferative glomerulonephritis the most frequent indication. Severe infection occurred in 9 patients (15%). Community acquired pneumonia was the most frequent infection with 3 cases (33%) followed by Herpes Zoster with 2 reports (22%). The cumulative dose of corticosteroid was the only significant risk factor for infection 32.8+16.7 vs. 20.1+15.3 P=.007.Conclusion: The use of lower doses of corticosteroids and an aggressive management of infectious complications, allows for an acceptable safety profile in patients treated with CYC. (C) 2014 Elsevier Espafia, S.L.U. All rights reserved.