학술논문
Invasive fungal diseases in patients with autoimmune diseases: a case series from the French RESSIF network
Document Type
article
Author
Vincent Poindron; Benjamin Terrier; François Maillot; Jean-Pierre Gangneux; Nassim Kamar; Valéry Salle; Lilia Hasseine; François Danion; Lilia Merabet; Guillaume Desoubeaux; Éric Bailly; Milène Sasso; Antoine Néel; Simon Galmiche; Benjamin Thoreau; Stéphane Bretagne; Alexandre Alanio; André Paugam; Valérie Letscher-Bru; Sophie Cassaing; Hélène Guegan; Loïc Favennec; Alida Minoza; Florent Morio; Julie Bonhomme; Odile Eloy; Laurence Millon; Anne-Pauline Bellanger; Philippe Poirier; Maxime Moniot; Taieb Chouaki; Antoine Huguenin; Frédéric Dalle; Bernard Bouteille; Muriel Nicolas; Nicole Desbois-Nogard; Marie-Elisabeth Bougnoux; Karine Boukris-Sitbon; Fanny Lanternier; Caroline Mahinc; Marc Pihet; Magalie Demar; Céline Damiani; Marie-Fleur Durieux; Elena Charpentier; Cécile Nourrisson; Benoit Suzon
Source
RMD Open, Vol 9, Iss 3 (2023)
Subject
Language
English
ISSN
2056-5933
51470667
51470667
Abstract
Objectives We aimed to describe patients with autoimmune diseases (AID) developing invasive fungal disease (IFD) and identify factors associated with short-term mortality.Methods We analysed cases of IFD associated with AID from the surveillance network of invasive fungal diseases (Réseau de surveillance des infections fongiques invasives, RESSIF) registry of the French national reference centre for invasive mycoses. We studied association of AID-specific treatments with 30-day mortality. We analysed total lymphocyte and CD4-T cell counts in patients with Pneumocystis jirovecii pneumonia (PCP).Results From 2012 to 2018, 549 individuals with IFD and AID were included, mainly with PCP (n=227, 41.3%), fungemia (n=167, 30.4%) and invasive aspergillosis (n=84, 15.5%). Rheumatoid arthritis (RA) and anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) were the most frequent AID in PCP (n=55 and 25, respectively) and invasive aspergillosis (n=15 and 10, respectively), inflammatory bowel diseases (IBDs) were predominant in fungemia (n=36). At IFD diagnosis, 365 (66.5%) patients received glucocorticoids (GCs), 285 (51.9%) immunosuppressants, 42 (7.7%) tumor necrosis factor (TNF)-α blockers, 75 (13.7%) other biologics. Mortality at 30 days was 28.1% (143/508). Fungemia and high-dose GCs were independently associated with higher 30-day mortality. In PCP patients, lymphopenia