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1996-03-04
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Document 0583
DOCN M9640583
TI Interstitial pneumonitis in patients infected with the human
immunodeficiency virus.
DT 9604
AU Griffiths MH; Miller RF; Semple SJ; Department of Histopathology,
University College London Medical; School, London, UK.
SO Thorax. 1995 Nov;50(11):1141-6. Unique Identifier : AIDSLINE
MED/96149316
AB BACKGROUND--A study was performed to identify the clinical,
radiographic, and histopathological features of interstitial pneumonitis
in patients infected with the human immunodeficiency virus. METHODS--A
retrospective review was made of the case notes, chest radiographs, and
histopathological results of seven HIV-1 antibody positive patients with
symptomatic diffuse pulmonary disease and a pathological diagnosis of
non-specific interstitial pneumonitis. RESULTS--All patients had
dyspnoea, with or without cough, and chest radiographs showing diffuse
infiltrates. The arterial oxygen tension ranged widely from 5.9 to 13.1
kPa. The initial clinical diagnosis was Pneumocystis carinii pneumonia
in most cases. The pathological diagnosis was made by transbronchial
biopsy in one case and by open lung biopsy in six cases. The
interstitial pneumonitis consisted of a patchy lymphocytic infiltrate
composed of B cells in focal aggregates and T cells in a more diffuse
distribution. The T cell population was a mixture of CD4+ and CD8+
cells. The histological findings contrast with the more extensive
infiltrate of predominantly CD8+ lymphocytes seen in HIV-associated
lymphocytic interstitial pneumonitis which occurs mainly in children.
The condition ran a subacute course. Three patients spontaneously
improved and three improved with steroid therapy. Long term survival was
less than three years, the prognosis being determined by other infective
or neoplastic complications. CONCLUSIONS--Non-specific interstitial
pneumonitis usually presents with an illness resembling Pneumocystis
carinii pneumonia but occurs when the CD4 and total lymphocyte counts
are still preserved. The pneumonitis resolves spontaneously or responds
to steroids, and does not itself lead directly to the patient's death.
It does, however, appear to mark a downturn in the course of HIV
infection.
DE Adult B-Lymphocytes Human HIV Infections/*COMPLICATIONS/MORTALITY
Lung/PATHOLOGY Lung Diseases, Interstitial/*DIAGNOSIS/DRUG
THERAPY/PATHOLOGY Male Middle Age Prednisolone/THERAPEUTIC USE
Retrospective Studies T-Lymphocytes JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).