Bronchoalveolar lavage (BAL) as a diagnostic tool in pulmonary hypertension: occult alveolar haemorrhage is a common feature of pulmonary veno-occlusive disease (PVOD)
A. Rabiller, O. Sitbon, F. Parent, V. Ioos, X. JAIS, A. Hamid, G. Garcia, A. Resten, S. Maitre, D. Musset, F. Capron, G. Simonneau, M. Humbert (Clamart, France)
Source: Annual Congress 2003 - Pulmonary hypertension
Session: Pulmonary hypertension
Session type: Oral Presentation
Number: 3533
Disease area: Pulmonary vascular diseases
Abstract PVOD is an uncommon cause of pulmonary hypertension (PH), that affects postcapillary pulmonary vessels. Patients suffering PVOD usually present similarly to patients with primary PH (PPH). One of the main complication of PVOD is the frequent onset of severe pulmonary edema with vasodilator therapy. As PVOD affects the postcapillary vasculature, it may be responsible for occult alveolar hemorrhage. The aim of this study was to assess the role of BAL in the non invasive approach of PVOD. 11 patients with PVOD and 11 matched PPH patients underwent routine PH evaluation. BAL was performed in all patients. Cytological analyses were performed and differential counts were made on Perls-stained preparations. The Golde score was used to assess alveolar hemorrhage. As compared with PPH, PVOD was characterized by significantly elevated alveolar cell counts (405,600 ± 325,300 cells/ml vs 204,300 ± 158,200 cells/ml, p=0.03). The percentage of macrophages, lymphocytes and neutrophils were similar. The percentage of hemosiderin laden macrophages was higher in PVOD than in PPH (54±37 % vs 3±6 %, p=0.0006). The Golde score was markedly elevated in PVOD (109±97 vs 4±10, p=0.0004). Occult alveolar hemorrhage appears to be a common feature of PVOD. A non invasive approach of PVOD including clinical, radiological and cytological analysis of BAL may be of interest.
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A. Rabiller, O. Sitbon, F. Parent, V. Ioos, X. JAIS, A. Hamid, G. Garcia, A. Resten, S. Maitre, D. Musset, F. Capron, G. Simonneau, M. Humbert (Clamart, France). Bronchoalveolar lavage (BAL) as a diagnostic tool in pulmonary hypertension: occult alveolar haemorrhage is a common feature of pulmonary veno-occlusive disease (PVOD). Eur Respir J 2003; 22: Suppl. 45, 3533
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