Evidence map›Paper›PMID 32915907›Full record

ArticlePloS one2020

Rituximab identified as an independent risk factor for severe PJP: A case-control study.

Anat Zalmanovich, Ronen Ben-Ami, Galia Rahav, Danny Alon, Allon Moses, Karen Olshtain-Pops, Miriam Weinberger, Pnina Shitrit, Michal Katzir, Bat-Sheva Gottesman and 1 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Prophylaxis forBMJ open · 2023
    Pooled it
  2. Article
  3. The 2025 EQUALJAC-antimicrobial resistance · 2025
    Article
  4. Human immunity to fungal infections.The Journal of experimental medicine · 2025
    Review
  5. Article
  6. Article
  7. Pathogens (Basel, Switzerland) · 2023
    Review
  8. Article
  9. Successful treatment of severeSAGE open medical case reports · 2023
    Article
  10. Avicenna journal of medicine · 2023
    Review
  11. The Pathogenesis and Diagnosis ofJournal of fungi (Basel, Switzerland) · 2022
    Review
  12. Article
  13. Article
  14. Duration of prednisone treatment before development ofJournal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2022
    Article
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Anat ZalmanovichDepartment of Internal Medicine A, Meir Medical Center, Kfar Saba, Israel.
Ronen Ben-AmiSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Galia RahavSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Danny AlonDepartment of Internal Medicine A, Meir Medical Center, Kfar Saba, Israel.
Allon MosesInfectious Disease Unit, Hadassah Medical Center, Jerusalem, Israel.
Karen Olshtain-PopsInfectious Disease Unit, Hadassah Medical Center, Jerusalem, Israel.
Miriam WeinbergerSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pnina ShitritSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Michal KatzirSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Bat-Sheva GottesmanSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Michal ChowersSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.ORCID 0000-0001-6148-254X
Tel Aviv University · ILHebrew University of Jerusalem · ILMeir Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePneumocystis jirovecii pneumonia (PJP) was reported among immunosuppressed patients with deficits in cell-mediated immunity and in patients treated with immunomodulatory drugs. The aim of this study was to identify risk-factors for PJP in noninfected HIV patients.

methodsThis retrospective, test negative, case-control study was conducted in six hospitals in Israel, 2006-2016. Cases were hospitalized HIV-negative patients with pneumonia diagnosed as PJP by bronchoalveolar lavage. Controls were similar patients negative for PJP.

resultsSeventy-six cases and 159 controls were identified. Median age was 63.7 years, 65% males, 34% had hematological malignancies, 11% inflammatory diseases, 47% used steroids and 9% received antilymphocyte monoclonal antibodies. PJP was independently associated with antilymphocyte monoclonal antibodies (OR 11.47, CI 1.50-87.74), high-dose steroid treatment (OR 4.39, CI 1.52-12.63), lymphopenia (OR 8.13, CI 2.48-26.60), low albumin (OR 0.15, CI 0.40-0.54) and low BMI (OR 0.80, CI 0.68-0.93).

conclusionIn conclusion, rituximab, which is prescribed for a wide variety of malignant and inflammatory disorders, was found to be significant risk-factor for PJP. Increased awareness of possible PJP infection in this patient population is warranted.

Indexed as

Pneumocystis cariniiAdultAgedAged, 80 and overAntilymphocyte SerumAntineoplastic Agents, ImmunologicalCase-Control StudiesFemaleHematologic NeoplasmsHIV SeronegativityHumansImmunologic FactorsIsraelMaleMiddle AgedMultivariate AnalysisAntilymphocyte SerumAntineoplastic Agents, ImmunologicalImmunologic FactorsRituximabSteroids

Identifiers

PMID32915907
PMCPMC7485893
OpenAlexW3086628730

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.