Blood eosinophilia in tacrolimus-treated patients: an indicator of Pneumocystis carinii pneumonia.
BACKGROUND
Pneumocystis carinii pneumonia (PcP) in immunocompromised patients is suggested if the following symptoms develop: dyspnea, fever, and interstitial infiltrates on chest x-ray. We observed a significant blood eosinophilia in kidney recipients with PcP under immunosuppressive treatment with tacrolimus.


METHODS
Blood eosinophil counts of kidney recipients under immunosuppression with tacrolimus suffering from PcP were compared to eosinophil counts of patients without evidence of PcP and to patients showing PcP under immunosuppression with cyclosporine.


RESULTS
PcP-positive patients treated with tacrolimus showed a significantly higher blood eosinophil count compared to PcP-positive patients treated with cyclosporine (P=0.01), and to patients under immunosuppression with tacrolimus without PcP, respectively (P=0.006). Eosinophilia preceded the time of a definitive PcP diagnosis by bronchoalveolar lavage and decreased after successful treatment.


CONCLUSIONS
An increasing blood eosinophil count can be an indicator of P. carinii pneumonia in patients under immunosuppressive therapy with tacrolimus.
Dickenmann
M J
MJ
Department of Internal Medicine, University Hospital, Basel, Switzerland.
Tamm
M
M
Tsinalis
D
D
Binet
I
I
Thiel
G
G
Steiger
J
J
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000139:chemically induced* / Q000150:complications; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine; D016559:Tacrolimus