       Document 0246
 DOCN  M9630246
 TI    Pneumocystis carinii pneumonia in patients without AIDS, 1980 through
       1993. An analysis of 78 cases.
 DT    9603
 AU    Arend SM; Kroon FP; van't Wout JW; Department of Infectious Diseases,
       University Hospital, Leiden,; The Netherlands.
 SO    Arch Intern Med. 1995 Dec 11-25;155(22):2436-41. Unique Identifier :
       AIDSLINE MED/96094911
 AB    BACKGROUND: Pneumocystis carinii pneumonia (PCP) occurs in
       immunocompromised patients without the acquired immunodeficiency
       syndrome (AIDS). There has been an increasing yearly number of cases of
       PCP in our patients without AIDS. OBJECTIVE: To determine the nature of
       the underlying disorder and previous immunosuppressive treatment in
       patients with PCP without AIDS. METHOD: A study of the charts of 78 such
       patients admitted to our hospital from 1980 through 1993. RESULTS: The
       number of PCP cases per year increased during the period studied. All
       patients had an underlying disorder, either hematologic malignancy
       (49%), solid organ tumor (4%), vasculitis or other immunologic disorder
       (22%), or they had undergone renal transplantation (17%) or bone marrow
       transplantation (9%). Previous immunosuppressive medication consisted of
       prednisone or other corticosteroids in 72 (92%) of 78 patients,
       cytotoxic drugs in 55 (71%) of 78 patients, both in 50 (64%) of 78
       patients, and none in one patient. Quantification of previous
       corticosteroid treatment showed a large variability among patients. The
       overall mortality rate for patients was 35% (27/78). Mortality was
       significantly higher in patients with a concomitant pulmonary infection
       (P = .01), an underlying disorder other than that which resulted in
       renal transplantation (P = .03), mechanical ventilation (P < .001),
       previous chemotherapy (P = .04), as well as previous cyclophosphamide
       treatment (P = .01). A trend toward a higher mortality in patients with
       previous corticosteroid use was detected (P = .06). CONCLUSION:
       Pneumocystis carinii pneumonia may complicate a variety of
       immunocompromised states, with considerable mortality. Pneumocystis
       carinii pneumonia occurred at all levels of immunosuppression; no
       threshold level could be defined.
 DE    Adolescence  Adult  Aged  Antineoplastic Agents/ADVERSE EFFECTS
       Causality  Comorbidity  Female  Human  *HIV Seronegativity
       *Immunocompromised Host  Immunosuppressive Agents/ADVERSE EFFECTS  Male
       Middle Age  Pneumonia, Pneumocystis
       carinii/*EPIDEMIOLOGY/ETIOLOGY/MORTALITY  Respiration,
       Artificial/ADVERSE EFFECTS  Retrospective Studies  Survival Analysis
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

