The indication for prophylaxis in patients with autoimmune diseases treated with rituximab must be individualized and should be considered, especially if patients receive corticosteroids at > 20 mg/day [54] or if other risk factors for PJP are present (old age, kidney or lung involvement, previous infections due to T cell–mediated immune dysfunction, lymphocytopenia, and low CD4 cell counts) [51, 53]. This evidence concerns the gene CD4 and lymphopenia.