Y. Arai et al., Clinical significance of the serum surfactant protein D and KL-6 levels inpatients with measles complicated by interstitial pneumonia, EUR J PED, 160(7), 2001, pp. 425-429
To examine the value of surfactant protein D and KL-6 as markers for the di
agnosis and the severity of interstitial pneumonia caused by measles infect
ion, surfactant protein D, KL-6 and lactic acid dehydrogenase were measured
serially in three patients with measles complicated by interstitial pneumo
nia as compared to ten measles infected patients without interstitial pneum
onia. The serum surfactant protein D and KL-6 levels were higher in patient
s with measles and interstitial pneumonia as compared to those with measles
without interstitial pneumonia. In patients with measles and interstitial
pneumonia, the respiratory distress and the alveolar-arterial oxygen differ
ences improved after steroid pulse therapy while the serum surfactant prote
in D level decreased dramatically under the cut-off level and earlier than
the KL-6 level. On the contrary, the serum KL-6 level increased transiently
and it took longer to decrease below the cut-off level as compared to the
pattern observed for serum surfactant protein D. The serum lactic acid dehy
drogenase level changes were between those of the surfactant protein D and
KL-6 levels.
Conclusion Surfactant protein D and KL-6 are easily measured and useful mar
kers for the diagnosis of interstitial pneumonia caused by measles infectio
n. Early decrease of surfactant protein D contrasts with the transient incr
ease of KL-6 levels after prednisolone pulse therapy.