el-Sadr W, Sidhu G, Diamond G, Zuger A, Berman D, Simberkoff M S, Rahal J J
AIDS Res. 1986 Fall;2(4):349-55. doi: 10.1089/aid.1.1986.2.349.
Three patients with severe Pneumocystis carinii pneumonia and acquired immunodeficiency syndrome, not responding to specific therapy with trimethoprim/sulfamethoxazole, were treated with a 24-hour course of high-dose methylprednisolone. Rapid improvements in the clinical status and the chest X-rays were detected. In two of the patients, in whom lung biopsy was performed before initiation of corticosteroids, an intense interstitial mononuclear cell infiltrate was seen. In the one patient who had lung biopsy after corticosteroid therapy, a scanty amount of mononuclear cells was demonstrated in the interstitium. Our experience suggests that corticosteroids may be useful as adjunctive agents in the treatment of severe P. carinii pneumonia not responding to specific anti-Pneumocystis therapy. This may be a result of inhibition of mononuclear cell accumulation within the lung by the steroid therapy.
三名患有严重卡氏肺孢子虫肺炎和获得性免疫缺陷综合征且对甲氧苄啶/磺胺甲恶唑特异性治疗无反应的患者接受了为期24小时的大剂量甲基强的松龙治疗。观察到临床状况和胸部X光迅速改善。在其中两名在开始使用皮质类固醇之前进行了肺活检的患者中，可见强烈的间质单核细胞浸润。在接受皮质类固醇治疗后进行肺活检的一名患者中，间质中仅显示少量单核细胞。我们的经验表明，皮质类固醇可能作为辅助药物用于治疗对特异性抗肺孢子虫治疗无反应的严重卡氏肺孢子虫肺炎。这可能是类固醇治疗抑制了肺内单核细胞积聚的结果。
