PURPOSE: Serum Lactate Dehydrogenase (LDH) levels are elevated in patients with Pneumocystis carinii Pneumonia (PCP) and it has been postulated that increased levels correlate with severity of illness. We sought to analyze this in a cohort of patients with confirmed PCP. METHODS: Retrospective review of patient records with PCP confirmed by bronchoscopy. Patients who had determinations of LDH and alveolar-arterial oxygen gradient while breathing room air (A-a gradient) on admission were analyzed. RESULTS: Sixty eight patients who had the above data were analyzed. Serum LDH ranged from 169-959 IU/l. A-a gradients ranged from 9-84 mm Hg. Correlation coefficient between the degree of LDH elevation and the widening of A-a gradient was 0.459 which signifies a weak correlation. CONCLUSIONS: There was no significant correlation between the degree of LDH elevation and the degree of A-a gradient widening in PCP. CLINICAL IMPLICATIONS: While LDH levels are often elevated in PCP, the degree of LDH elevation does not predict severity of illness. LDH should not be used as a prognostic marker while making therapeutic decisions.
|Published - Oct 1996