Source: Annual Congress 2002 - Interstitial lung disorders: markers of disease activity and severity
Disease area: Interstitial lung diseases

Abstract

In this analysis we assessed whether the likelihood for specific lung diseases changed with the knowledge of BAL cell differentials. As initial guess (a priori probability), frequencies of final diagnoses were taken, which had been affirmed through all available information except BAL. Via a Bayesian approach we then computed a posteriori probabilities for each disease on the basis of cell differentials, using different categorisations for the counts. The analysis was performed separately for three groups of suspected diagnoses: interstitial lung disease (ILD, n=395), inflammatory disease (n=365), or lung tumor mimicking interstitial disease (n=358). Overall, a priori probabilities were 18.9 % for sarcoidosis, 7.7 % for UIP, 5 % for EAA, and 22.7 % for tumors. Within the group of suspected ILD, the likelihood for sarcoidosis increased from 30.6 to 61.7 % when lymphocyte numbers were >30 %, that for UIP increased from 16.5 to 32.7 % when lymphocyte numbers were <30 % and granulocyte numbers >4 %. The likelihood of rare diseases never rised to appreciable values. Parallel results were obtained within the other two groups. These data suggest that BAL cell counts provide substantial diagnostic information only for relatively frequent diseases such as sarcoidosis and UIP; they are less helpful for infrequent diseases.
Supported by the LVA Hamburg

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Citations should be made in the following way:
L. Welker, R. A. Jörres, H. Magnussen (Grosshansdorf, Germany). BAL cell counts in the diagnosis of lung diseases: is there a gain in information?. Eur Respir J 2002; 20: Suppl. 38, 1119

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