{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T20:00:01Z","timestamp":1774296001760,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2010,6,25]],"date-time":"2010-06-25T00:00:00Z","timestamp":1277424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Wegener's granulomatosis (WG) is a devastating small\u2010vessel vasculitis in children. Standard treatment consists of immunosuppressive medications with cyclophosphamide potentially associated with significant infectious side effects, including <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia (PCP). Recently, rituximab, a monoclonal antibody against B cells, has successfully been used in refractory disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe the first pediatric patient with refractory WG with sinus and lung disease who developed PCP 6 months after treatment with rituximab, while being treated with methotrexate and prednisone. This 9\u2010year\u2010old child had no CD20+ B cells at time of infection, with normal lymphocyte and CD4 counts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study provides a review of the published literature, including current protocols, which suggest chemoprophylaxis only in WG patients receiving T cell\u2013targeted immunosuppression such as cyclophosphamide. However, clinical and laboratory evidence points toward a possible role of B cells in the defense against PCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Routine PCP chemoprophylaxis should be strongly considered in patients with WG treated with rituximab.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.20279","type":"journal-article","created":{"date-parts":[[2010,6,25]],"date-time":"2010-06-25T11:22:06Z","timestamp":1277464926000},"page":"1661-1664","source":"Crossref","is-referenced-by-count":52,"title":["<i>Pneumocystis jiroveci<\/i> pneumonia following rituximab treatment in Wegener's granulomatosis"],"prefix":"10.1002","volume":"62","author":[{"given":"Boris","family":"Hugle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"James","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupma","family":"Wadhwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reshma","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Bell\u2010Peter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Benseler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,2]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.22774"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199904)42:4<780::AID-ANR23>3.0.CO;2-M"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-007-8026-1"},{"key":"e_1_2_5_5_2","first-page":"1006","article-title":"Rituximab for refractory childhood autoimmune hemolytic anemia","volume":"4","author":"Motto DG","year":"2002","journal-title":"Isr Med Assoc J"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken234"},{"key":"e_1_2_5_7_2","first-page":"246","article-title":"Pneumocystis carinii pneumonia in the course of connective tissue disease: report of 34 cases","volume":"21","author":"Godeau B","year":"1994","journal-title":"J Rheumatol"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.3.7881673"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005590.pub2"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.088096"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.4065\/82.9.1052"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/173.4.1034"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.176.10.6147"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.171.3.1423"},{"key":"e_1_2_5_15_2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1007\/s00431-003-1200-4","article-title":"X\u2010linked agammaglobulinaemia and Pneumocystis carinii pneumonia: an unusual coincidence?","volume":"162","author":"Dittrich AM","year":"2003","journal-title":"Eur J Pediatr"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.24998"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.20279","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.20279","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:58:18Z","timestamp":1759424298000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.20279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2010,11]]}},"alternative-id":["10.1002\/acr.20279"],"URL":"https:\/\/doi.org\/10.1002\/acr.20279","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11]]}}}