Journal Information
Vol. 30. Issue 4.
Pages 192-195 (April 1994)
Share
Share
Download PDF
More article options
Vol. 30. Issue 4.
Pages 192-195 (April 1994)
Full text access
Neutrofilia en el lavado broncoalveolar de pacientes con sida y neumonía por Pneumocystis carinii. Consideraciones sobre su valor pronóstico en nuestro medio
Neutrophilia in the bronchoalveolar lavage of patients with AIDS and Pneumocystis carinii pneumonía. Reflections on its prognostic value in our context
Visits
4482
J. Gea, X. Aran, J.M. Broquetas
Servicios de Neumología. Hospital del Mar. Barcelona
J. Sauleda*,1, E. Gimferrer**, M. Conangla**
** Servicios de Anatomía Patológica. Hospital del Mar. Barcelona
* Servicio de Neumología. Hospital Son Dureta. Palma de Mallorca
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

Se analiza el valor pronóstico en nuestro medio de la neutrofilia (> 5%) en el lavado broncoalveolar (LBA) de 21 pacientes con sida y neumonía por Pneumocystis carinii.

La neutrofilia no parece revelarse como un buen marcador pronóstico en nuestro entorno. Así hemos hallado que sólo el 33% de nuestra población tenía neutrofília, con una cifra media de 6 ± 4%. La sensibilidad de dicho parámetro respecto al riesgo de fallecer fue muy baja (25%), con una moderada especificidad (65%).

Contrastando con lo referido en algunos trabajos precedentes del ámbito anglosajón, la neutrofília en el LBA es probablemente de escasa utilidad pronostica en nuestro medio. Ello sería fruto de diversos factores, entre los que cabría destacar el tipo de población (en su mayoría adictos a drogas por vía parenteral, ADVP) y la modalidad terapéutica utilizada (tratamiento empírico y precoz).

The prognostic valué of neutrophilia (> 5%) in bronchoalveolar lavage (BAL) in our context is studied in 21 patients with AIDS and Pneumocystis carinii pneumonia.

Neutrophilia does not seem to be a good prognostic indicator in our context. We have found this condition, with a mean of 6 ± 4%, in only 33% of our sample. The sensitivity of this parameter with respect to risk of death was very low (25%), while specificity was moderate (65%).

In contrast with what has been reported in studies done with Anglo-Saxon populations, neutrophilia in BAL is probably of little prognostic use in our context. This may be due to various factors, among them the type of population (most being intravenous drug users) and the therapeutic protocol (early empirical treatment).

Full text is only aviable in PDF
Bibliografía
[1.]
Centers for Disease Control.
Update: Acquired Immunodeficiency Syndrome (AIDS)-USA.
MMWR, 35 (1986), pp. 17-21
[2.]
G.R. Mason, C.H. Hashimoto, P.S. Dickman, L.F. Foutty, C.J. Cobb.
Prognostic implications of bronchoalveolar lavage neutrophilia in patients with Pneumocystis carinii pneumonia and AIDS.
Am Rev Respir Dis, 139 (1989), pp. 1 336-1. 342
[3.]
R.L. Smith, W.M. El Sadr, M.L. Lewis.
Correlation of bronchoalveolar lavage cell populations with clinical severity of Pneumocystis carinii pneumonia.
Chest, 93 (1988), pp. 60-64
[4.]
R.J. Kaner, D.E. Stover.
Prognostic implications of bronchoalveolar lavage neutrophilia in patients with Pneumocystis carinii pneumonia and AIDS.
Am Rev Respir Dis, 139 (1989), pp. 1.322-1.324
[5.]
K.R. Young, J.A. Rankin, G.P. Naegel, E.S. Paul, H.Y. Reynolds.
Bronchoalveolar lavage cells and proteins in patients with the Acquired Immunodeficiency Syndrome.
Ann Intern Med, 103 (1985), pp. 522-533
[6.]
M. Brenner, F.P. Ognibene, E.E. Lack, et al.
Prognostic factors and life expectancy of patients with Acquired Immunodeficiency Syndrome and Pneumocystis carinii pneumonia.
Am Rev Respir Dis, 136 (1987), pp. 1.199-1.206
[7.]
S.M. Garay, J. Greene.
Prognostic indicators in the initial presentation of Pneumocystis carinii pneumonia.
Chest, 95 (1989), pp. 769-772
[8.]
M.K. Zaman, D.A. White.
Serum lactate dehydrogenase levels and Pneumocystis carinii pneumonia.
Am Rev Respir Dis, 137 (1988), pp. 796-800
[9.]
F.T. Kagawa, C.M. Kirsch, G.G. Yenokida, M.L. Levine.
Serum lactate dehydrogenase activity in patients with AIDS and Pneumocystis carinii pneumonia.
Chest, 94 (1988), pp. 1.031-1.033
[10.]
R.L. Smith, C.S. Ripps, M.L. Lewis.
Elevated lactate dehydrogenase values in patients with Pneumocystis carinii pneumonia.
Chest, 93 (1988), pp. 987-992
[11.]
W. El-Sadr, M.S. Simberkoff.
Survival and prognostic fators in severe Pneumocystis carinii pneumonia requiring mechanical ventilation.
Am Rev Respir Dis, 137 (1988), pp. 1.264-1.267
[12.]
J. Gea, R. Rodríguez-Roisin, J. Roca, et al.
Ventilation-Perfusion inequality in patients with pneumonia Effects of 100% oxygen and postural changes.
Am Rev Respir Dis, 137 (1988), pp. 271
[13.]
P. Hanly, A. Sienko, R.B. Light.
Role of endogenous prostaglandins in the hemodynamic changes during acute experimental pseudomonas pneumonia with bacteriemia.
Am Rev Respir Dis, 133 (1986), pp. 77
[14.]
R.B. Light.
Intrapulmonary oxygen consumption in experimental pneumococcal pneumonia.
J Appl Physiol, 64 (1988), pp. 2.490-2.495
[15.]
J. Gea, A. Agustí, G.N. Roca, et al.
Lack of intrapulmonary oxygen consumption in patients with severe pneumonia requiring mechanical ventilation.
Am Rev Respir Dis, 141 (1990), pp. 929
[16.]
G.N. Agustí A, J. Roca, J. Gea, P.D. Wagner, A. Xaubet, R. Rodríguez-Roisin.
Mechanism of gas exchange impairment in idiopathic pulmonary fibrosis.
Am Rev Respir Dis, 143 (1991), pp. 219-225
[17.]
R.J. Kaner.
Prognostic implications of bronchoalveolar lavage neutrophilia in patients with Pneumocystis carinii pneumonia and AIDS: Effects of an aggressive therapeutic approach.
Am Rev Respir Dis, 141 (1990), pp. 1.081
[18.]
G.R. Mason.
Prognostic implications of bronchoalveolar lavage neutrophilia in patients with Pneumocystis carinii pneumonia and AIDS: Effects of an aggressive therapeutic approach.
Am Rev Respir Dis, 141 (1990), pp. 1.081
[19.]
D.E. Stover.
Presumed Pneumocystis carinii pneumonia should be treated empirically in patients with the Acquired Immunodeficiency syndrome.
Am Rev Respir Dis, 138 (1988), pp. 1.076-1.077
[20.]
J. Soler-Bel, A. Tapiz, R. Miralles, J.M. Garcés Jarque.
Efectos adversos del cotrimoxazol y neumonía por Pneumocystis carinii.
Rev Clin Esp, 184 (1989), pp. 85-86
Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?