TY - JOUR
T1 - Recommendations for the management of pulmonary fungal infections in patients with rheumatoid arthritis
AU - Galli, Massimo
AU - Antinori, Spinello
AU - Atzeni, Fabiola
AU - Meroni, Luca
AU - Riva, Agostino
AU - Scirè, Carlo A.
AU - Adorni, Fulvio
AU - Quartuccio, Luca
AU - Sebastiani, Marco
AU - Airò, Paolo
AU - Bazzichi, Laura
AU - Cristini, Francesco
AU - Del Bono, Valerio
AU - Manfredi, Andreina
AU - Viapiana, Ombretta
AU - De Rosa, Francesco
AU - Favalli, Ennio
AU - Petrelli, Enzo
AU - Salvarani, Carlo
AU - Govoni, Marcello
AU - Corcione, Silvia
AU - Scrivo, Rossana
AU - Sarmati, Loredana
AU - Lazzarin, Adriano
AU - Grassi, Walter
AU - Mastroianni, Claudio
AU - Gaeta, Giovanni Battista
AU - Ferraccioli, Gianfranco
AU - Cutolo, Maurizio
AU - De Vita, Salvatore
AU - Lapadula, Giovanni
AU - Matucci-Cerinic, Marco
AU - Armignacco, Orlando
AU - Sarzi-Puttini, Piercarlo
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Often life-threatening pulmonary fungal infections (PFIs) can occur in patients with rheumatoid arthritis (RA) receiving disease-modifying anti-rheumatic drugs (DMARDs). Most of the data concerning PFIs in RA patients come from case reports and retrospective case series. Of the five most widely described PFIs, Pneumocystis jirovecii pneumonia (PJP) has rarely been seen outside Japan, pulmonary cryptococcosis has been diagnosed in only a small number of patients worldwide, pulmonary coccidioidomycosis has almost only been observed in endemic areas, the limited number of cases of pulmonary histoplasmosis have mainly occurred in the USA, and the rare cases of invasive pulmonary aspergillosis have only been encountered in leukopenic patients. Many aspects of the prophylaxis, diagnosis and treatment of PFIs in RA patients remain to be defined, as does the role of each DMARD in increasing the risk of infection, and the possibility of resuming biological and non-biological DMARD treatment after the infection has been cured. The recommendations for the management of PFIs described in this paper are the product of a consensus procedure promoted by the Italian group for the Study and Management of Infections in Patients with Rheumatic Diseases (the ISMIR group).
AB - Often life-threatening pulmonary fungal infections (PFIs) can occur in patients with rheumatoid arthritis (RA) receiving disease-modifying anti-rheumatic drugs (DMARDs). Most of the data concerning PFIs in RA patients come from case reports and retrospective case series. Of the five most widely described PFIs, Pneumocystis jirovecii pneumonia (PJP) has rarely been seen outside Japan, pulmonary cryptococcosis has been diagnosed in only a small number of patients worldwide, pulmonary coccidioidomycosis has almost only been observed in endemic areas, the limited number of cases of pulmonary histoplasmosis have mainly occurred in the USA, and the rare cases of invasive pulmonary aspergillosis have only been encountered in leukopenic patients. Many aspects of the prophylaxis, diagnosis and treatment of PFIs in RA patients remain to be defined, as does the role of each DMARD in increasing the risk of infection, and the possibility of resuming biological and non-biological DMARD treatment after the infection has been cured. The recommendations for the management of PFIs described in this paper are the product of a consensus procedure promoted by the Italian group for the Study and Management of Infections in Patients with Rheumatic Diseases (the ISMIR group).
KW - Fungal infection
KW - Pneumonia
KW - Recommendations
KW - Rheumatoid arthritis
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M3 - Review article
AN - SCOPUS:85040565526
VL - 35
SP - 1018
EP - 1028
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
SN - 0392-856X
IS - 6
ER -