TY - JOUR T1 - Prognostic impact of pre-existing interstitial lung disease in non-HIV patients with <em>Pneumocystis</em> pneumonia JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00306-2019 VL - 6 IS - 2 SP - 00306-2019 AU - Shohei Hamada AU - Hidenori Ichiyasu AU - Megumi Inaba AU - Hiroshi Takahashi AU - Tomoki Sadamatsu AU - Kimitaka Akaike AU - Aiko Masunaga AU - Yasumasa Tashiro AU - Naomi Hirata AU - Takeshi Yoshinaga AU - Takuro Sakagami Y1 - 2020/04/01 UR - http://openres.ersjournals.com/content/6/2/00306-2019.abstract N2 - Background The increasing incidence of life-threatening Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients is a global concern. Yet, no reports have examined the prognostic significance of pre-existing interstitial lung disease (ILD) in non-HIV PCP.Methods We retrospectively reviewed the medical records of non-HIV PCP patients with (ILD group) or without (non-ILD group) pre-existing ILD. The clinical features and outcomes of the ILD group were compared with those of the non-ILD group. Cox regression models were constructed to identify prognostic factors.Results 74 patients were enrolled in this study. The 90-day mortality was significantly higher in the ILD group than in the non-ILD group (62.5% versus 19.0%, p&lt;0.001). In the ILD group, patients with a higher percentage of bronchoalveolar lavage fluid neutrophils had worse outcomes compared to those having a lower percentage (p=0.026). Multivariate analyses revealed that pre-existing ILD (p=0.002) and low levels of serum albumin (p=0.009) were independent risk factors for 90-day mortality. Serum levels of β-d-glucan were significantly reduced after treatment of PCP in both groups, whereas levels of Krebs von den Lungen-6 (KL-6) significantly increased in the ILD group. In the ILD group, the 90-day mortality of patients with increasing KL-6 levels after treatment was significantly higher than those with decreasing levels (78.9% versus 0%, p=0.019).Conclusion In non-HIV PCP patients, pre-existing ILD is associated with a poorer prognosis. Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression.Pre-existing interstitial lung disease (ILD) is an independent prognostic risk factor for non- HIV Pneumocystis pneumonia (PCP). Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression. http://bit.ly/37BGZuK ER -