关键词: 肾小球肾炎, 耶氏肺孢子菌肺炎, 儿童

Abstract: Objective　To understand the clinical characteristics and prognosis of glomerular disease children with Pneumocystis pneumonia (PCP). Method　A retrospective analysis was conducted on the clinical features, laboratory examinations, treatment, and prognosis of 12 children diagnosed with glomerular disease complicated with PCP in Xi'an Children's Hospital from June 2019 to August 2024. Results　Among the 12 children, there were 7 boys and 5 girls, with an age of (10.19±3.29) years old. The basic diseases were mainly lupus nephritis and IgA nephropathy. Shortness of breath was common in the clinical manifestations, but the pulmonary signs were not obvious. Only 3 cases had moist rales heard in both lungs. The lymphocyte count and CD4+ lymphocyte count in the blood of 12 children were both decreased to varying degrees. Among them, the CD4+ lymphocyte count of 10 children was less than 200/ul. The lactate dehydrogenase (LDH) levels of all cases were increased to varying degrees, with a median value of 586.5 (422.0, 1 084.5) U/L. The 1-3β-glucan level of 12 children was (165.27±103.26) ng/L, and 9 of them showed an increase. The other common specific pathogen was cytomegalovirus (5 cases, accounting for 41.67%). All 12 children were treated with sulfamethoxazole-trimethoprim, and 5 of them were also given micafungin. The mortality rate was 33.33% (4/12). Conclusions　For children with glomerulonephritis, if they have fever, cough, and shortness of breath but no obvious lung signs, especially if their CD4+ lymphocyte count is decreased, it is necessary to be vigilant of concurrent PCP. Early diagnosis and treatment should be carried out to reduce the mortality rate.

Key words: Glomerulonephritis, Pneumocystis pneumonia, Children