Background and objective A high frequency of infections complicating rheumatoid arthritis (RA) has been reported due to the immunomodulatory effect of RA or to agents with immunosuppressive effects used in its treatment. We aimed to assess clinical and radiological characteristics of pulmonary cryptococcosis in patients with and without RA. Methods We retrospectively reviewed the medical records of 52 patients with pulmonary cryptococcosis and divided them into two groups, those with RA and without RA, and compared clinical characteristics and radiological findings between them. Results Eleven (21.2%) of the 52 patients had RA. Median follow-up periods were 51.2 (range: 1.1–258.7) months for patients with RA and 19.1 (range: 0.63–246.9) months for patients without RA. Among the patients with RA, 81.8% were women, with a mean age of 68.1 years. Female sex and respiratory comorbidities were significantly more frequent in patients with RA than in patients without RA. Frequencies of concomitant cryptococcal meningitis and respiratory failure were not different between the groups. There were no significant differences in frequency of any radiological findings, locations and number between the two groups. Among patients with RA, all but one responded well to antifungal treatment. During the antifungal treatment course, one (9.1%) patient with RA died of cryptococcosis. Despite continuing antirheumatic drugs, no patients had recurrence of pulmonary cryptococcosis during follow-up. Conclusion Other than some differences in background, there were no clinical, radiological or prognostic differences between the patients with and without RA with pulmonary cryptococcosis. The administration of antirheumatic therapy had no negative effect on the clinical course of antifungal treatment. No data are available.

中文翻译：

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类风湿关节炎患者肺隐球菌病的特点

背景和目的 由于 RA 的免疫调节作用或其治疗中使用的具有免疫抑制作用的药物，已经报道了高频率的类风湿性关节炎 (RA) 并发感染。我们旨在评估患有和不患有 RA 的患者肺隐球菌病的临床和放射学特征。方法回顾性分析52例肺隐球菌病患者的病历，将其分为RA组和非RA组，比较两组患者的临床特征和影像学表现。结果 52 名患者中有 11 名 (21.2%) 患有 RA。RA 患者的中位随访期为 51.2（范围：1.1-258.7）个月，非 RA 患者的中位随访期为 19.1（范围：0.63-246.9）个月。在RA患者中，81.8%为女性，平均年龄为68.1岁。RA 患者中女性和呼吸道合并症的发生率明显高于非 RA 患者。伴随隐球菌性脑膜炎和呼吸衰竭的频率在各组之间没有差异。两组之间任何放射学发现的频率、位置和数量没有显着差异。在 RA 患者中，除 1 人外，所有人都对抗真菌治疗反应良好。在抗真菌治疗过程中，一名 (9.1%) RA 患者死于隐球菌病。尽管继续服用抗风湿药物，但在随访期间没有患者出现肺隐球菌病复发。结论 除了一些背景差异外，肺隐球菌病合并RA和不合并RA患者在临床、影像学或预后方面没有差异。抗风湿治疗对抗真菌治疗的临床过程没有负面影响。没有可用数据。