PRESENCE OF GLOMERULAR-BASEMENT-MEMBRANE (GBM) ANTIBODIES IN HIV- PATIENTS WITH PNEUMOCYSTIS-CARINII PNEUMONIA

Following the unexpected finding of antibodies to GEM in a patient wit h Pneumocystis carinii pneumonia in the absence of kidney abnormalitie s, the presence of anti-GEM antibodies was analysed in 14 patients wit h pulmonary P. carinii infection who did not have clinical evidence of autoimmune glomerulonephritis. Patients were divided into three group s: HIV- with P. carinii pneumonia (n = 4), HIV+ with P. carinii pneumo nia (n = 5) and HIV- carriers of P. carinii without pneumonia (n = 5). As control groups, HN - patients with community-acquired non-P. carin ii pneumonia (n = 6) and healthy individuals (n = 16) were included. A nti-GEM antibodies, studied with a quantitative enzyme immuno-assay (E IA) for anti-alpha 3 chain of collagen IV antibodies, were detected in three out of the four HIV- patients with P. carinii pneumonia, but no t in any individuals of the other categories. These results suggest th at P. carinii alveolar injury or the host response to the organism cou ld affect the basal membrane Goodpasture antigen or a similar antigen, and induces anti-GEM antibody production in HIV- patients, and suppor t the hypothesis that, at least in some cases, Goodpasture's syndrome could be triggered by an alveolar lesion induced by a P. carinii pneum onia.