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Pneumocystis carinii pneumonia in childhood systemic lupus erythematosus
H E Foster1, P N Malleson, R E Petty
1Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Insights
Pneumocystis pneumonia (PCP) is a rare but serious complication in children with systemic lupus erythematosus (SLE). Early recognition of respiratory symptoms is crucial for timely diagnosis and management of this opportunistic infection.
Area of Science:
- Pediatric Rheumatology
- Infectious Diseases
- Immunology
Background:
- Pneumocystis pneumonia (PCP) is a known complication in adult patients with systemic lupus erythematosus (SLE).
- PCP is rarely documented in pediatric cases of SLE.
- This study focuses on the occurrence and risk factors of PCP in children with SLE.
Objective:
Although Pneumocystis carinii pneumonia (PCP) is known to occur in adults with systemic lupus erythematosus (SLE), this infection has rarely been described in childhood SLE. We describe 3 children with SLE who developed PCP and describe risk factors for this complication.
Methods:
A retrospective case review.
Results:
All 3 children had severe active SLE with organ involvement requiring immunosuppressive therapy, but the clinical presentations of PCP differed in each patient. They shared some of the known risk factors for opportunistic infection in adults with SLE, including lymphopenia, but severe lymphopenia (< 0.35 x 10(9)/1) was not seen.
Conclusion:
PCP is an uncommon but serious complication of childhood SLE, and should be considered in the presence of respiratory symptoms, however subtle. The role of oral chemoprophylaxis is discussed.