S-adenosylmethionine concentrations in diagnosis of Pneumocystis carinii pneumonia

Lancet. 2003 Apr 12;361(9365):1267-8. doi: 10.1016/S0140-6736(03)12984-4.


Pneumocystis carinii is unable to synthesise S-adenosylmethionine and thus scavenges this intermediate. We aimed to test whether measurement of concentrations of this metabolic intermediate in plasma could provide a new method for rapid diagnosis of Pneumocystis carinii pneumonia (PCP). We measured S-adenosylmethionine plasma concentrations in 12 healthy controls, 16 patients with confirmed or suspected PCP, and 36 patients with other infections. Median concentration in healthy controls was 106 nmol/L (range 86-128), but the protein was undetectable in eight patients with histologically proven and seven with suspected PCP, and was 8 nmol/L in another confirmed case (p<0.0001). In 36 patients with other infections, S-adenosylmethionine concentrations were much the same as in controls: 18 had bacterial pneumonia, two tuberculosis, five cryptococcal meningitis, three had other infections, and eight had asymptomatic HIV-1 infection. After treatment for PCP, S-adenosylmethionine concentrations rose rapidly in all but one patient who died of the disease. Measurement of plasma S-adenosylmethionine concentrations could prove useful for diagnosis of PCP and assessment of patients' response to treatment.

MeSH terms

  • AIDS-Related Opportunistic Infections / blood
  • AIDS-Related Opportunistic Infections / diagnosis*
  • Case-Control Studies
  • HIV Infections / blood
  • HIV Infections / complications
  • Humans
  • Pneumonia, Bacterial / blood
  • Pneumonia, Pneumocystis / blood
  • Pneumonia, Pneumocystis / diagnosis*
  • S-Adenosylmethionine / blood*


  • S-Adenosylmethionine