PNEUMOCYSTIS-CARINII PNEUMONIA IN CHILDHOOD SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective, Although Pneumocystis carinii pneumonia (PCP) is known to o ccur in adults with systemic lupus erythematosus (SLE), this infection has rarely been described in childhood SLE, We describe 3 children wi th SLE who developed PCP and describe risk factors for this complicati on. Methods. A retrospective case review. Results. All 3 children had severe active SLE with organ involvement requiring immunosuppressive t herapy, but the clinical presentations of PCP differed in each patient . They shared some of the known risk factors for opportunistic infecti on ih adults with SLE, including lymphopenia, but severe lymphopenia ( < 0.35 x 10(9)/1) was not seen. Conclusion. PCP is an uncommon but ser ious complication of childhood SLE, and should be considered in the pr esence of respiratory symptoms, however subtle. The role of oral chemo prophylaxis is discussed.