Mason GR, Foutty LL, Dickman PS; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 287 (abstract no. T.B.P.3).
Harbor-UCLA Medical Center, Torrance CA, 90509, USA
OBJECTIVE: In 60 patients with PCP, greater than 5% BAL neutrophils predicted morbidity more sensitively and specifically than the degree of hypoxemia, hypoalbuminemia or increased LDH (Am Rev Resp Dis, in press). We sought to determine a pathologic basis of excess bronchoalveolar lavage (BAL) neutrophil percentages in Pneumocystis carinii pneumonia. METHODS: Transbronchial biopsies of 29 patients with documented PCP and specimens adequate to assess the histology the lung parenchyma were reviewed. Biopsies were scored from 0 (absent) to 3 (easily found in most fields) for the degree of diffuse alveolar damage (DAD) and for the presence of polymorphonuclear leukocytes (PMN's) as well as the presence of organisms, edema, chronic inflammation, fibrosis and intra-alveolar or interstitial PMN's. RESULTS: The presence of DAD and interstitial or intra-alveolar PMN's were the most common abnormalities in the lung parenchyma and each was found in 27 of 29 patients. The presence of fibrosis was the least common finding, present in only 6 of 27 patients. CONCLUSIONS: DAD and neutrophilic infiltration were commonly found in the transbronchial lung biopsies in patients with AIDS. Neutrophilic infiltrates are not a well-recognized sequelae of PCP, however, PMN's in the lung may account for more severe clinical manifestations of this disease and provide the basis for staging of PCP with BAL neutrophils.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Biopsy
- Humans
- L-Lactate Dehydrogenase
- Lung
- Neutrophils
- Pneumonia, Pneumocystis
Other ID:
UI: 102177241
From Meeting Abstracts