title: Serum lactate dehydrogenase activity in patients with AIDS and Pneumocystis carinii pneumonia. An adjunct to diagnosis.
abstract: We investigated whether serum lactate dehydrogenase activity (LD) is significantly elevated in patients with acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia (PCP) when compared to patients with non-Pneumocystis pneumonia. We measured LD (U/L), blood total lymphocyte count (1,000/cu mm), and alveolar-arterial oxygen tension difference P(A-a)O2 (mm Hg), in 30 patients with AIDS and PCP (group 1), four patients with AIDS or AIDS-related complex (ARC) and non-Pneumocystis pneumonia (NPCP) (group 2), and seven patients with pneumococcal pneumonia and bacteremia (PPB) (group 3). In patients with AIDS and PCP, LD was 509 +/- 35 (mean +/- SE), which was significantly elevated in comparison to both AIDS/ARC patients with NPCP (228 +/- 21) (p less than .001), and patients with PPB (211 +/- 21) (p less than .001). There was a significant positive correlation between LD and P(A-a)O2 (r = .51, p = 0.01). P(A-a)O2 was markedly elevated in both AIDS patients with PCP (48 +/- 3), and patients with pneumococcal pneumonia (44 +/- 3), but only moderately elevated in AIDS/ARC patients with NPCP (29 +/- 6). These results suggest that measurement of LD may be useful in differentiating Pneumocystis pneumonia from non-Pneumocystis pneumonia. In addition, the increase in LD correlates with the degree of pulmonary oxygen transfer abnormality.
authors.affiliation: Division of Pulmonary Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128.
authors.forename: F T
authors.initials: FT
authors.lastname: Kagawa
authors.forename: C M
authors.initials: CM
authors.lastname: Kirsch
authors.forename: G G
authors.initials: GG
authors.lastname: Yenokida
authors.forename: M L
authors.initials: ML
authors.lastname: Levine
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000201:enzymology*; D000328:Adult; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D011008:Pneumococcal Infections / Q000201:enzymology; D011014:Pneumonia / Q000201:enzymology; D011018:Pneumonia, Pneumococcal / Q000201:enzymology; D011020:Pneumonia, Pneumocystis / Q000201:enzymology* / Q000209:etiology; D018805:Sepsis / Q000201:enzymology
chemical_list: D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase