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Haemophilia, AIDS and lung epithelial permeability
Author(s) -
O'Doherty M. J.,
Page C. J.,
Harrington C.,
Nunan T.,
Savidge G.
Publication year - 1990
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1990.tb00388.x
Subject(s) - medicine , lung , pneumocystis carinii , asymptomatic , pneumonia , gastroenterology , pneumocystis jirovecii
Lung 99m Tc DTPA transfer was measured in HIV antibody‐positive haemophiliacs (11 smokers, 26 nonsmokers, 5 patients with Pneumocystis carinii pneumonia (PCP)). Lung 99m Tc DTPA transfer as a marker of lung epithelial permeability was measured as the half time of transfer (from airspace into blood). This half time was faster in smokers compared to nonsmokers and the transfer curve was monoexponential. In nonsmokers no difference was observed between asymptomatic HIV‐positive haemophiliacs and normal subjects, with the exception of the lung bases. At the lung bases in HIV‐positive haemophiliac nonsmokers the transfer was faster than in normal individuals, implying increased alveolar permeability. Pneumocystis carinii pneumonia resulted in a rapid transfer of 99m Tc DTPA (mean T50 of 2 minutes) and the transfer curve was biphasic, confirming previous observations in homosexual HIV antibody‐positive patients with PCP. These changes returned to a monoexponential profile by 6 weeks following successful treatment. The DTPA lung transfer study may enable clinicians to instigate therapy for PCP without the need for initial bronchoscopy and provide a noninvasive method for the reassessment of patients should further respiratory signs or symptoms develop. This method is considered to be highly cost‐effective in that it obviates the use of factor VIII concentrates required to cover bronchoscopic procedures and, with its early application and ease of use as a follow‐up investigation, permits the evaluation of patients on an outpatient basis, thus reducing hospital costs.