Opportunistic infections in polymyositis and dermatomyositis
Article first published online: 7 APR 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis Care & Research
Volume 53, Issue 2, pages 155–165, 15 April 2005
How to Cite
Marie, I., Hachulla, E., Chérin, P., Hellot, M.-F., Herson, S., Levesque, H. and Hatron, P.-Y. (2005), Opportunistic infections in polymyositis and dermatomyositis. Arthritis & Rheumatism, 53: 155–165. doi: 10.1002/art.21083
- Issue published online: 7 APR 2005
- Article first published online: 7 APR 2005
- Manuscript Accepted: 29 NOV 2004
- Manuscript Received: 7 JUL 2004
- Opportunistic infections;
- Predictive factors
To assess prevalence and characteristics of opportunistic infections in patients with polymyositis/dermatomyositis (PM/DM). To determine the predictive values for opportunistic infections on clinical presentation, biochemical findings, and paraclinical features of PM/DM to detect patients at risk of opportunistic infections.
The medical records of 156 consecutive PM/DM patients in 3 medical centers were reviewed.
Eighteen PM/DM patients (11.5%) developed opportunistic infections. The majority of patients exhibited an opportunistic infection after the onset of PM/DM (89% of cases). Opportunistic infections occurred most frequently during the first year following PM/DM diagnosis (62.5%). The pathogen microorganisms responsible for opportunistic infections were various, i.e., Candida albicans, Pneumocystis carinii, Aspergillus fumigatus, Geotrichum capitatum, Mycobacteriumavium-intracellulare complex, M. xenopi, M. marinum, M. tuberculosis, Helicobacter heilmanii, cytomegalovirus, and herpes simplex virus. Mortality rates were as high as 27.7% in these PM/DM patients. Higher mean daily doses of steroids, lymphopenia, and lower serum total protein levels were significantly more frequent in the group of PM/DM patients with opportunistic infections.
Our study underscores the high frequency of opportunistic infections in PM/DM, resulting in an increased mortality rate. It also indicates that a great variety of microorganisms are responsible for opportunistic infections, although they were more often due to fungi (>50% of cases). Our series highlights a predominance of both lung and digestive opportunistic infections (89% of cases). In addition, our results suggest that PM/DM patients presenting with factors predictive of opportunistic infection may require closer monitoring.