Kinetics of serum β-D-glucan after Pneumocystis pneumonia treatment in patients with AIDS

Intern Med. 2011;50(13):1397-401. doi: 10.2169/internalmedicine.50.5296. Epub 2011 Jul 1.

Abstract

Objective: Serum β-D-glucan has been demonstrated as a reliable, adjunct diagnostic marker for PCP, but its kinetics after PCP treatment are poorly understood. To evaluate the correlation between the levels of β-D-glucan and the clinical response, we investigated the individual transition of serum β-D-glucan levels after the initiation of PCP treatment.

Methods: Retrospective study

Patients: Seventeen PCP patients with AIDS who were admitted to our hospital were analyzed.

Results: All subjects showed the serum β-D-glucan levels above the cut-off value, and the median level was 224 pg/mL [IQR: 78-597] at the time of PCP diagnosis. There were no correlations between serum β-D-glucan levels and CRP, LDH, or AaDO(2) at room air. Although there was a downward trend in serum β-D-glucan level as PCP treatment was initiated, a significant number of subjects showed a marked increase in the serum β-D-glucan levels despite their evident clinical improvement.

Conclusion: The serum β-D-glucan level does not reflect the severity and prognosis of PCP infection, and thus it may not be suitable for monitoring the response to treatment.

Publication types

  • Comparative Study

MeSH terms

  • Acquired Immunodeficiency Syndrome / blood*
  • Acquired Immunodeficiency Syndrome / therapy*
  • Adult
  • Biomarkers / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumocystis carinii*
  • Pneumonia, Pneumocystis / blood*
  • Pneumonia, Pneumocystis / diagnosis
  • Pneumonia, Pneumocystis / therapy*
  • Retrospective Studies
  • Treatment Outcome
  • beta-Glucans / blood*
  • beta-Glucans / pharmacokinetics

Substances

  • Biomarkers
  • beta-Glucans