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Older patients with pemphigus have highest risk of opportunistic infections

In a historical, prospective study, researchers found a significant risk of opportunistic infections during the first year after pemphigus diagnosis, more so in older patients, and possibly also in diabetic patients.

The chart review cohort comprised 172 patients newly diagnosed with pemphigus and followed-up within the designated 10-year period; mean follow-up time was 3.5 years.

Fourteen patients developed opportunistic infections (OIs) exclusively during the first year after pemphigus diagnosis, at an average interval of 4 months from diagnosis. All patients required hospitalization.

First-year incidence rate of OIs was 8.1%, subsequently dropping to 0; however, the risk may have been an underestimation, as 23 of the patients who did not develop an OI had less than 1 year of follow-up and could have developed an OI later, according to the researchers.

After accounting for the loss to follow-up during the first year of study, OI incidence rate in the first year following pemphigus diagnosis was 9.3 OIs per 100 patients.

Age at diagnosis and presence of diabetes were found to be significantly associated with OI development, whereas sex and treatment regimens were not, according to the researchers.

Through a logistic approach, the researchers adjusted for diabetes influence and found the association between age at diagnosis and OI showed an additional 4% estimate of risk difference for each year of age. Although the adjusted association between diabetes and development of OI was still strong, the risk estimate was of borderline significance, according to the researchers.

Disclosure: The researchers reported no financial disclosures.