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Five children with positive serology for human immunodeficiency virus (HIV) infection by enzyme-linked immunosorbent assay and Western blot were followed for chronic pulmonary disease. Lung biopsies were performed in all patients, and confirmed the diagnosis of pulmonary lymphoid hyperplasia. All children demonstrated progressive hypoxia and increasing alveolar capillary oxygen gradients over at least 1 year of follow-up. All children were on periodic intravenous gamma globulin treatment for a B-cell defect prior to the initiation of corticosteroid therapy. Prednisone was initially given at a dose of 2 mg/kg daily and was subsequently tapered to an alternate day regimen. All children showed improvement in oxygenation. No deterioration in immune function was noted, and there was no increase in bacterial infection. This study indicates that corticosteroids can successfully reverse the severe hypoxia that may result from pulmonary lymphoid hyperplasia in pediatric AIDS patients.

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So. F l o r i d a , Oept. o f P e d a t r i c s , Tampa, FL Plasma zinc l e v e l s have been v a r i a b l y reported a s low o r normal i n p a t i e n t s with c y s t i c f i b r o s i s (CF). Zinc i s a co-factor f o r more than 60 enzymes including t h e A6 d e s a t u r a s e enzyme, and may be required f o r t h e mobilization and t r a n s p o r t of vitamin A, reported t o be low i n p a t i e n t s with CF. Zinc is a l s o important i n immune function. For t h e s e reasons, zinc i s a p o t e n t i a l l y important mineral i n p a t i e n t s with CF. We measured zinc and v i tamin A l e v e l s i n 25 p a t i e n t s with CF (ages 5-29) and compared them t o c o n t r o l s . CF p a t i e n t s have s i g n i f i c a n t l y lower plasma zinc, 70.12 + 2.66 and vitamin A, 30.13 f 1.51, than do c o n t r o l s (94.11 2 3.21 and 47.85 f 4.41, r e s p e c t i v e l y , p10.001, p<0.001). Plasma zinc but not vitamin A l e v e l s corresponded t o t h e degree of pulmonary involvement (normal o r mildly a f f e c t e d 78.72 + 4.34, moderately t o severely a f f e c t e d 63.65 ? 1.89, p<0.001), but not t o the presence of pancreatic i n s u f f i c i e n c y . S i x p a t i e n t s were supplemented with zinc gluconate f o r 6 weeks with 3 mg/kg/day. Plasma zinc l e v e l s r o s e s i g n f i c a n t l y , although t h e r e was no obvious change observed i n t h e i r c l i n i c a l s t a t u s . Plasma copper l e v e l s , which have a r e c i p r o c a l r e l a t i o n s h i p with plasma zinc, decreased s i g n i f i c a n t l y but remained within t h e normal range. A longer period of supplementation may be required t o bring about a change i n c l i n i c a l s t a t u s . Previous c o n f l i c t i n g r e p o r t s of zinc s t a t u s i n CF may r e f l e c t heterogeneity of pulmonary involvement between groups of p a t i e n t s s t u d i e d . TREATMENT OF AIDS ASSOCIATED LYMPHOID INTERSTITIAL 1742PNEuMoNITIs WITH INTRAVENOUS GAwGLoBuLIN AND PREDNISONE. Morris Charytan, Ben Zion Krieger, Andrew Wiznia, Larry Bernstein, Bernard Silverman, and Arye Rubinstein, Albert E i n s t e i n College of Medicine, Department of P e d i a t r i c s , Microbiology and Immunology, Bronx, New York.6 c h i l d r e n w i t h Acquired Immunodeficiency Syndrome and biopsy proven lymphoid i n t e r s t i t i a l pneumonitis were t r e a t e d on a p r o t o c o l of intravenous gammaglobulin and c o r t i c o s t e r o i d s . I n d i c a t i o n s f o r therapy were a c l i n i c a l h i s t o r y of severe and/or r e c u r r e n t episodes of r e s p i r a t o r y d i s t r e s s responsive t o intravenous a n t i b i o t i c s and hypoxemia p e r s i s t i n g a f t e r r e s o l u t i o n of t h e a c u t e i l l n e s s . Hypoxemia was defined a s a p02C70 t o r r on t h r e e determinations. Therapy consisted of an i n i t i a l period of loading w i t h intravenous gammaglobulin. Duration and dosage of loading varied w i t h t h e s e v e r i t y of t h e c l i n i c a l circumstances. C o r t i c o s ...