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Query: UMLS:C0032285 (
pneumonia
)
54,520
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
To determine the sensitivity of serum KL-6 and serum
lactate dehydrogenase
for detecting the contraction of radiation
pneumonitis
, 15 patients with lung cancer who had radiation therapy were monitored. Six of the patients contracted radiation
pneumonitis
(
pneumonitis
group) and the other patients did not (control group). Serum levels of KL-6 were significantly (p less than 0.05) elevated according to the complication of radiation
pneumonitis
in all patients of the
pneumonitis
group. In the control group, however, one-sided changes of KL-6 level were not observed. In the
pneumonitis
group, serum LDH levels were not significantly changed. However, there was a strong correlation between the altered levels of KL-6 and those of LDH (r = 0.992). These observations indicate that the same cytopathologic changes may cause the elevation of serum KL-6 level and the elevated activity of serum LDH in the patients with radiation
pneumonitis
, and that KL-6 is much more sensitive than LDH for detecting radiation
pneumonitis
.
...
PMID:Circulating antigen KL-6 and lactate dehydrogenase for monitoring irradiated patients with lung cancer. 132 May 62
It has been previously demonstrated that serum
lactate dehydrogenase
is elevated among HIV patients with pneumocystis carinii
pneumonia
(PCP). To evaluate the clinical utility of this test we analyzed the admission LDH levels of patients hospitalized for the first time due to the secondary complications of AIDS. Among 76 patients without a prior history of PCP, 41 (54%) had PCP diagnosed during their hospitalization while 35 (46%) did not have PCP. Serum LDH was significantly higher among PCP patients than in patients without PCP (mean = 423 IU/L vs 234 IU/L). Receiver operating characteristic curve analysis demonstrated that at an optimal cutoff point of LDH greater than or equal to 240 IU/L, the test sensitivity and specificity were 0.78 and 0.74 respectively among all hospitalized patients. However, when only patients with dyspnea were considered, the optimal test sensitivity and specificity improved to 0.94 and 0.78 at a cutoff point of LDH greater than or equal to 220 IU/L. Comparing the areas under fitted ROC curves, serum LDH was a significantly better discriminator among patients with dyspnea than among those who were not short of breath. We conclude that while serum LDH is strongly associated with the presence of PCP among AIDS patients, it is a poor screening test for PCP when applied to all hospitalized AIDS patients with and without respiratory complaints. Serum LDH is no substitute for appropriate microbiological studies. However, with further evaluation, it may prove to be a useful test in guiding the clinical management of dyspneic patients in whom sputum or bronchial examinations are negative or not immediately available.
...
PMID:The clinical utility of serum lactate dehydrogenase in diagnosing pneumocystis carinii pneumonia among hospitalized AIDS patients. 151 88
Serum marker KL-6 antigen has been reported to be a valuable indicator of the disease activity of interstitial pneumonia. It is not clear how sensitive the serum KL-6 antigen level is in reflecting histologic changes in lung tissues. We report here the results of serial measurements of serum KL-6 antigen in a 76-year-old male patient with radiation
pneumonia
. Serum KL-6 antigen levels were more sensitive than
lactate dehydrogenase
and procollagen type III N-terminal peptide. The level of serum KL-6 antigen appears to reflect the histologic changes of the lung more sensitively than does C-reactive protein.
...
PMID:Monitoring of serum KL-6 antigen in a patient with radiation pneumonia. 154 Nov 62
Four out of eleven patients--none of them HIV positive--who received treatment for non-Hodgkin lymphoma by the MACOP-B protocol between June 1989 and February 1990 were taken ill during or shortly after the conclusion of the course with fulminant
pneumonia
necessitating artificial ventilation. In three cases Pneumocystis carinii was identified as the pathogen, and in one patient the diagnosis of pneumocystosis seemed probable. The mean cumulative doses given before the outbreak of
pneumonia
were as follows: cyclophosphamide 2753 +/- 1161 mg, methotrexate 1590 +/- 667 mg, bleomycin 36 +/- 16.8 mg and prednisone 4378 +/- 1734 mg. The mean haemoglobin concentration was 10.7 +/- 0.5 g/dl, leucocyte count 5250 +/- 2100/microliters, lymphocyte count 1300 +/- 300/microliters and
lactate dehydrogenase
227 +/- 34 U/l. The cumulative doses and laboratory findings in the seven patients not affected by pneumocytosis were not significantly different. The patients with
pneumonia
were supported by mechanical ventilation for 6-26 days and treated with large doses of corticosteroids and co-trimoxazole. One patient died after 17 days' ventilation. Three patients were successfully weaned from the ventilator. Chemotherapy protocols such as MACOP-B predispose to acute Pneumocystis pneumonia. The risk of infection is independent of the cumulative doses of the drugs employed. For this reason, prophylaxis with co-trimoxazole is normally mandatory.
...
PMID:[Acute pneumocystosis during polychemotherapy following the MACOP-B protocol]. 169 17
A total of 92 patients with previously untreated intermediate- or high-grade non-Hodgkin's lymphoma attending the University Department of Medicine, Queen Mary Hospital, Hong Kong, were treated with the m-BACOD chemotherapy regimen (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine and dexamethasone). Additional involved-field radiotherapy was given to 32 (35%) patients. Myelosuppression was the major toxicity, and 5 (5%) treatment-related deaths occurred due to
pneumonia
, bleomycin sensitivity, doxorubicin cardiotoxicity and reactivation of hepatitis B infection. The overall complete response (CR) rate was 65/92 (71%) and the relapse rate was 22/65 (34%). The disease-free survival of the 65 CR patients at 2 years was 52% and the overall survival of all 92 patients at 3 years was 56%. The CR rate of stage I and II patients was significantly better than that of those with stage III and IV disease (87% vs 59%; P = 0.01), and the CR rate of stage III patients was superior to that of those with stage IV disease (86% vs 50%; P = 0.05). The overall survival of stage III and IV patients was significantly worse than that of subjects with stage I and II disease (31% vs 73%; P = 0.02). Multivariate analysis revealed that the independent prognostic variables significantly determining the CR rate and survival included the clinical stage and the serum
lactate dehydrogenase
level. From this study, the results of treatment with the m-BACOD regimen in patients with advance disease appeared to be similar to those obtained using the conventional CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone).
...
PMID:m-BACOD chemotherapy for intermediate- and high-grade non-Hodgkin's lymphoma. 171 34
Pneumonia
caused by common pyogenic bacteria occurs frequently in HIV-infected patients. Its clinical presentation has been described as being similar to that seen in non-immunosuppressed hosts but clearly different to that of opportunistic pneumonias. An atypical presentation has rarely been seen. In a 10-month period, we saw 12 HIV-infected patients who presented with Haemophilus influenzae pneumonia which was clinically and radiologically indistinguishable from Pneumocystis carinii pneumonia. Ten of the patients were intravenous drug users and were in different stages of HIV disease. The clinical picture was characterized by a prolonged course (median 4 weeks), non-productive cough, dyspnoea, and absence of findings usually present in bacterial pneumonia. Laboratory data frequently showed absence of leukocytosis, increased
lactate dehydrogenase
levels, hypoxaemia, and decreased CD4+ cell counts. All presented with interstitial or mixed bilateral infiltrates. Resistance to ampicillin and trimethoprim-sulphamethoxazole were each found in seven cases. Eleven patients were cured with antibiotic therapy, although five relapsed. H. influenzae
pneumonia
should be considered in HIV-infected patients who present with pulmonary symptoms and bilateral infiltrates of subacute or chronic onset. Clinical resolution of
pneumonia
is the usual outcome, but recurrences of infection are frequent.
...
PMID:Latent Haemophilus influenzae pneumonia in patients infected with HIV. 177 77
The clinical presentation of 60 consecutive Pneumocystis carinii pneumonias in 58 HIV-infected patients (48 men, 10 women, mean age 34 [22-53] years) was prospectively evaluated from April to August 1989 and compared with 60 consecutive P. carinii pneumonias in 59 HIV-infected patients (55 men, 4 women, mean age 37.5 [22-60] years) between 1981-88. Mortality rates within 14 days after diagnosis of P. carinii
pneumonia
were 50% (8 of 16 patients) until 1985, 20.5% (9 of 44) between 1986 and August 1988, and 1.7% (one of 60) in 1989. The degree of severity of the pneumonias at time of diagnosis was markedly lower in 1989, as shown by following parameters (averages of 1989, compared with averages of 1981-88):
lactate dehydrogenase
540 (250-1419) U/l versus 680 (235-1920) U/l (not significant); alveolo-arterial difference of partial oxygen tension (pA-aO2) 22.9 (0.5-73.5) mmHg versus 39.7 (19-70) mmHg (P less than 0.001); score of radiological findings 1.4 (0-3) versus 2.7 (0-4) (P less than 0.001). In 1989, mainly clinical symptoms (dry cough: 57 of 60 cases, dyspnea: 44 of 60 cases, fever: 43 of 60 cases) initiated the diagnostic procedure: chest radiographs,
lactate dehydrogenase
and pA-aO2 were normal in 13, 25 and 33 episodes, respectively. The lower mortality rate of P. carinii
pneumonia
could not primarily be explained by therapeutical progress since the treatment of choice did not change fundamentally since 1981. Above all, early diagnosis fundamentally determined the probability of survival.
...
PMID:[Pneumocystis carinii pneumonia in HIV infection: better prognosis because of early diagnosis]. 222 63
The values of some basic laboratory features on admission to hospital were recorded and compared in 418 adult patients with community-acquired
pneumonia
, namely erythrocyte sedimentation rate, C-reactive protein, white blood cell (WBC) count, serum
lactate dehydrogenase
(S-LD), serum alanine-aminotransferase, and serum sodium. Discriminant analysis was performed to obtain an aetiological diagnosis. WBC value of greater than 15 x 10(9)/l strongly indicated a bacterial and, especially a pneumococcal aetiology, whereas increased S-LD could imply a mycoplasmal infection. For patients less than 50 years of age the equation C2 = -1.788 + 0.204 x WBC-0.0909 X S-LD was constructed, in which C2 greater than 0 indicated a pneumococcal aetiology. This function correctly classified 31/33 (93.9%) patients with a mycoplasmal and 20/31 (64.5%) patients with a pneumococcal infection. Patients with viral, Haemophilus influenzae or chlamydial infection could not be discriminated from each other. The age of the patient, WBC and possibly S-LD on admission are easily accessible parameters and these results could therefore be of value in daily clinical practice in hospitals.
...
PMID:Rapid aetiological diagnosis of pneumonia based on routine laboratory features. 225 62
Two major pulmonary diseases were defined on the basis of lung biopsies in 15 children with acquired immune deficiency syndrome (AIDS) or AIDS-related complex. Pneumocystis carinii pneumonia was observed in eight children, and pulmonary lymphoid hyperplasia in six. One child had nonspecific interstitial pneumonitis. Children with P. carinii
pneumonia
had more severe hypoxemia, with higher alveolar-arterial oxygen gradients, and higher isomorphic elevations of serum
lactate dehydrogenase
. Clinically, children with pulmonary lymphoid hyperplasia were older, and had digital clubbing, parotid gland enlargement, and elevated serum IgG levels. Results of serologic assays and lung tissue analysis were suggestive of persistent Epstein-Barr virus infection exclusively in patients with pulmonary lymphoid hyperplasia. Recognition of the clinical and laboratory findings characteristic of each entity may assist in the differential diagnosis without the need of surgical biopsy.
...
PMID:Pulmonary disease in children with acquired immune deficiency syndrome and AIDS-related complex. 300 14
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.
...
PMID:Serum lactate dehydrogenase activity in patients with AIDS and Pneumocystis carinii pneumonia. An adjunct to diagnosis. 326 59
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