Correlation of bronchoalveolar lavage findings to severity of Pneumocystis carinii pneumonia in AIDS. Evidence for the development of high-permeability pulmonary edema.
We correlated bronchoalveolar lavage findings with the clinical course and outcome of Pneumocystis pneumonia. Forty-eight patients with AIDS and a confirmed diagnosis of P carinii pneumonia were studied. Patients with additional pulmonary infections were excluded. On the basis of BAL findings, they were divided into those with a low neutrophil count (less than 5 percent) and those with a high neutrophil count (greater than or equal to 5 percent). Sixteen patients with AIDS but without PCP served as a control group. All BAL fluid samples from the control group showed a low neutrophil count. The group with PCP and a high neutrophil count had more severe respiratory compromise and greater morbidity than the group with PCP and a low neutrophil count. Mortality rate was not different. The group showing a high BALF neutrophil count also showed a higher BALF protein concentration, a higher ratio of BALF protein concentration to plasma protein concentration, and the presence of alpha 2-globulins compared with other groups. These findings suggest that increased alveolar-capillary permeability occurs during severe PCP.
Sadaghdar
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H
Department of Medicine, St. Lukes/Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York.
Huang
Z B
ZB
Eden
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E
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000418:Albumins / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000276:immunology*; D002199:Capillary Permeability; D004804:Eosinophils; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology* / Q000401:mortality; D010100:Oxygen / Q000097:blood; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000276:immunology* / Q000401:mortality; D011506:Proteins / Q000032:analysis; D011654:Pulmonary Edema / Q000209:etiology* / Q000276:immunology
D000418:Albumins; D011506:Proteins; D010100:Oxygen