According to previous reports, high risk factors for rheumatic disease complicated with PJP included granulomatosis with polyangiitis; microscopic polyangiitis; autoimmune interstitial pneumonia; use of high-dose glucocorticoids, cyclophosphamide [16], or high-dose methotrexate; being older; having diabetes or nutritional deficiency; and severe lymphocytopenia or low CD4+ T cell counts [17, 18]. Here, CD4 is linked to diabetes mellitus.