Source: Annual Congress 2001 - Interstitial lung disease: BAL in diagnosis and management
Disease area: Interstitial lung diseases

Abstract

The aim of this study was to determine which of the BAL parameters do reflect the severity of newly diagnosed pulmonary sarcoidosis.
74 previously untreated patients with biopsy-proven, newly diagnosed sarcoidosis and 48 age-matched healthy controls were included in this study. Due to established clinical criteria, the sarcoid patients were divided into three groups: 10 patients with Löfgren's syndrome, 51 patients with stable disease and 13 patients with progressing disease in whom a systemic steroid therapy had to be initiated.
The total cell count, percentage of alveolar macrophages (AM) and lymphocytes, as well as the CD4/CD8-ratio were not associated with the severity of disease. Interestingly, we observed a significant increase of neutrophils (5.2 ±] 1.1 %; p = 0.0005 vs. controls) and eosinophils in sarcoid patients with progressing disease (1.7 ±] 0.6 %, p < 0.0005 vs. controls). An association between an elevated percentage of neutrophils in the BAL and the necessity for a systemic steroid therapy was not only observed in patients with an advanced sarcoidosis (radiological type III or IV) but also in sarcoid patients with earlier stages (radiological type I, II).
In conclusion, our results demonstrate that an increased percentage of neutrophils (> 3.0 %) and eosinophils (> 1.0 %) in the BALF of newly diagnosed sarcoid patients reflects the disease severity and may be helpful markers of a progressive disease.

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Citations should be made in the following way:
M. W. Ziegenhagen, M. Rothe, M. Schlaak, J. Müller-Quernheim (Borstel, Germany). Is the severity of newly diagnosed pulmonary sarcoidosis reflected by bronchoalveolar lavage (BAL) parameters?. Eur Respir J 2001; 16: Suppl. 31, 3417

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