S-adenosylmethionine concentrations in diagnosis of Pneumocystis carinii pneumonia.
Pneumocystis carinii is unable to synthesise S-adenosylmethionine and thus scavenges this intermediate. We aimed to test whether measurement of concentrations of this metabolic intermediate in plasma could provide a new method for rapid diagnosis of Pneumocystis carinii pneumonia (PCP). We measured S-adenosylmethionine plasma concentrations in 12 healthy controls, 16 patients with confirmed or suspected PCP, and 36 patients with other infections. Median concentration in healthy controls was 106 nmol/L (range 86-128), but the protein was undetectable in eight patients with histologically proven and seven with suspected PCP, and was 8 nmol/L in another confirmed case (p<0.0001). In 36 patients with other infections, S-adenosylmethionine concentrations were much the same as in controls: 18 had bacterial pneumonia, two tuberculosis, five cryptococcal meningitis, three had other infections, and eight had asymptomatic HIV-1 infection. After treatment for PCP, S-adenosylmethionine concentrations rose rapidly in all but one patient who died of the disease. Measurement of plasma S-adenosylmethionine concentrations could prove useful for diagnosis of PCP and assessment of patients' response to treatment.
Skelly
Michael
M
Department of Medicine, New York University-Bellevue Hospital Center, New York, NY, USA.
Hoffman
Julie
J
Fabbri
Marilyn
M
Holzman
Robert S
RS
Clarkson
Allen B
AB
Merali
Salim
S
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000175:diagnosis*; D016022:Case-Control Studies; D015658:HIV Infections / Q000097:blood / Q000150:complications; D006801:Humans; D018410:Pneumonia, Bacterial / Q000097:blood; D011020:Pneumonia, Pneumocystis / Q000097:blood / Q000175:diagnosis*; D012436:S-Adenosylmethionine / Q000097:blood*
D012436:S-Adenosylmethionine