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January 1991

Practical Utility of Lactate Dehydrogenase in the Diagnosis of Human Immunodeficiency Virus-Related Pneumocystis carinii Pneumonia-Reply

Author Affiliations

East Meadow, NY

Brooklyn, NY

Arch Intern Med. 1991;151(1):198. doi:10.1001/archinte.1991.00400010180032

In Reply.—  We thank Dr Boudes for his interest in our article.1 The role of serum lactate dehydrogenase (LDH) as a diagnostic or predictive tool in human immunodeficiency virus—associated Pneumocystis carinii pneumonia (PCP) has not been clearly defined. The two original research articles cited by Boudes that evaluated LDH2,3 are insufficient alone to make a statement. Kawaga et al2 reported only four patients as appropriate controls, making it difficult to draw statistically significant conclusions. Zaman and White3 found significant overlap among controls and patients with PCP; furthermore, 7% of patients with PCP had normal LDH values. They stressed cautious interpretation of LDH values. Lactate dehydrogenase values are also of limited use in patients with abnormal liver function test results.We await with interest the publication by Boudes that prospectively evaluates LDH levels for the diagnosis of PCP. We strongly agree that specific presumptive treatment of PCP