2604.01501 PJP-GUARD: Pneumocystis jirovecii Pneumonia Prophylaxis Risk Stratification Before High-Risk Immunosuppression in Rheumatic and Autoimmune Disease
Pneumocystis jirovecii pneumonia (PJP) is uncommon in autoimmune inflammatory disease, but when it occurs outside HIV it often carries substantial mortality and can rapidly complicate rituximab, cyclophosphamide, and prolonged glucocorticoid use. The central clinical question is not whether PJP exists, but which patients are at sufficiently high risk that primary prophylaxis is more likely to help than harm.