Digestive Diseases and Sciences

, Volume 52, Issue 6, pp 1481–1484

Pneumocystis jiroveci (carinii) Pneumonia After Infliximab Therapy: A Review of 84 Cases

Original Paper

DOI: 10.1007/s10620-006-9250-x

Cite this article as:
Kaur, N. & Mahl, T.C. Dig Dis Sci (2007) 52: 1481. doi:10.1007/s10620-006-9250-x

Abstract

Anti-tumor necrosis factor-α therapy, infliximab, has become an established effective therapy for Crohn's disease and rheumatoid arthritis. However, infliximab has been associated with various opportunistic pathogens such as tuberculosis, histoplasmosis, listeriosis, aspergillosis, and Pneumocystis jiroveci (carinii) pneumonia. We reviewed the FDA Adverse Event Reporting System for cases of Pneumocystis associated with infliximab use from January 1998 through December 2003. The database revealed 84 cases of PCP following infliximab therapy. Concomitant immunosuppressive medications included methotrexate, prednisone, azathioprine, 6-mercaptopurine, and cyclosporine. Mean time between infliximab infusion and onset of symptoms of pneumonia, when reported, was 21 days (±18 days; n=40). Twenty-three of the 84 (27%) patients died. The use of infliximab is associated with PCP infection. Further, the mortality rate for Pneumocystis following the use of infliximab is significant. The potential for severe disease, mortality, and often subtle presentation of these infections warrant close follow-up and careful monitoring after therapy.

Keywords

InfliximabRemicadePneumocystisInfectionPneumonia

Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  2. 2.Division of GastroenterologyDepartment of Medicine, VA Upstate New York, State University of New York at Buffalo School of MedicineBuffaloUSA