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Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases.
Rheumatology (Oxford). 2004 Apr; 43(4):479-85.R

Abstract

OBJECTIVES

We evaluated the polymerase chain reaction (PCR) detection of Pneumocystis carinii DNA in induced sputum of patients with connective tissue diseases and assessed the clinical features of patients positive for P. carinii.

METHODS

Sputum was induced by nebulization in 29 in-patients with various connective tissue diseases who presented with symptoms suggestive of P. carinii pneumonia (PCP), and was examined by PCR.

RESULTS

Detection of P. carinii DNA by PCR was significantly more sensitive than cytology; 54.5% patients were positive by PCR and only 4.5% by cytology. The prevalence of PCP was higher than previously considered and was especially high in patients receiving > 30 mg/day prednisolone with or without other immunosuppressants. P. carinii-positive patients had significant lymphocytopenia and a low serum IgG level compared with P. carinii-negative patients. P. carinii disappeared within 7-10 days after therapy with trimethoprim/sulfamethoxazole.

CONCLUSION

We propose that the use of PCR for detection of P. carinii using induced sputum is a useful and non-invasive method that has high sensitivity and specificity for the early diagnosis of PCP.

Authors+Show Affiliations

Saito K
First Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Fukuoka, Japan.
Nakayamada S
No affiliation info available
Nakano K
No affiliation info available
Tokunaga M
No affiliation info available
Tsujimura S
No affiliation info available
Nakatsuka K
No affiliation info available
Adachi T
No affiliation info available
Tanaka Y
No affiliation info available

MeSH

AdultAgedConnective Tissue DiseasesDNA, FungalFemaleHumansMaleMiddle AgedOpportunistic InfectionsPneumocystis cariniiPneumonia, PneumocystisPolymerase Chain ReactionRisk FactorsSputum

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

14762223

Citation

Saito, K, et al. "Detection of Pneumocystis Carinii By DNA Amplification in Patients With Connective Tissue Diseases: Re-evaluation of Clinical Features of P. Carinii Pneumonia in Rheumatic Diseases." Rheumatology (Oxford, England), vol. 43, no. 4, 2004, pp. 479-85.
Saito K, Nakayamada S, Nakano K, et al. Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. Rheumatology (Oxford). 2004;43(4):479-85.
Saito, K., Nakayamada, S., Nakano, K., Tokunaga, M., Tsujimura, S., Nakatsuka, K., Adachi, T., & Tanaka, Y. (2004). Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. Rheumatology (Oxford, England), 43(4), 479-85.
Saito K, et al. Detection of Pneumocystis Carinii By DNA Amplification in Patients With Connective Tissue Diseases: Re-evaluation of Clinical Features of P. Carinii Pneumonia in Rheumatic Diseases. Rheumatology (Oxford). 2004;43(4):479-85. PubMed PMID: 14762223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. AU - Saito,K, AU - Nakayamada,S, AU - Nakano,K, AU - Tokunaga,M, AU - Tsujimura,S, AU - Nakatsuka,K, AU - Adachi,T, AU - Tanaka,Y, Y1 - 2004/02/03/ PY - 2004/2/6/pubmed PY - 2004/6/23/medline PY - 2004/2/6/entrez SP - 479 EP - 85 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 43 IS - 4 N2 - OBJECTIVES: We evaluated the polymerase chain reaction (PCR) detection of Pneumocystis carinii DNA in induced sputum of patients with connective tissue diseases and assessed the clinical features of patients positive for P. carinii. METHODS: Sputum was induced by nebulization in 29 in-patients with various connective tissue diseases who presented with symptoms suggestive of P. carinii pneumonia (PCP), and was examined by PCR. RESULTS: Detection of P. carinii DNA by PCR was significantly more sensitive than cytology; 54.5% patients were positive by PCR and only 4.5% by cytology. The prevalence of PCP was higher than previously considered and was especially high in patients receiving > 30 mg/day prednisolone with or without other immunosuppressants. P. carinii-positive patients had significant lymphocytopenia and a low serum IgG level compared with P. carinii-negative patients. P. carinii disappeared within 7-10 days after therapy with trimethoprim/sulfamethoxazole. CONCLUSION: We propose that the use of PCR for detection of P. carinii using induced sputum is a useful and non-invasive method that has high sensitivity and specificity for the early diagnosis of PCP. SN - 1462-0324 UR - https://www.unboundmedicine.com/medline/citation/14762223/Detection_of_Pneumocystis_carinii_by_DNA_amplification_in_patients_with_connective_tissue_diseases:_re_evaluation_of_clinical_features_of_P__carinii_pneumonia_in_rheumatic_diseases_ DB - PRIME DP - Unbound Medicine ER -