Bronchoalveolar Lavage in Liquid Paraffin Pneumonitis: Results (5)

BALF Biochemical Analysis
After overnight decantation or low-speed centrifugation, the BALF from the patients with liquid paraffin pneumonitis often was separated into an upper oily layer and a lower clearer phase. The upper layer represented a small fraction, less than 20 percent of the 10 ml aliquot protein. Protein content was increased in the lower phase of patients 1,5, and 7, and was in the normal range (mean±SD) for the other patients (Table 3). Phospholipids also were increased in the lower phase of patients 1 and 5.
The TLC of the BALF-extracted lipids showed, for each patient with liquid paraffin pneumonitis, sphingomyelin, phosphatidylcholine and phosphatidyletha-nolamine migrating as the control spots in the solvent system for phospholipids (Fig 4, left). An abnormal hydrophobic compound migrating on the solvent front as the control paraffin was found for each patient. This abnormal spot was very slightly stained by iodine vapor. In the solvent system for neutral lipids, this abnormal compound still migrated on the solvent front as did the control paraffin and was well separated from the other neutral lipids (Fig 4, right). This abnormal spot isolated by TLC was definitely identified as liquid paraffin by comparative infrared spectroscopy and gas liquid chromatography for patient l. buy levaquin online
The BALF from the seven patients with PAP contained large amounts of proteins as compared to the control subjects (p<0.01) or to the patients with liquid paraffin pneumonitis (p<0.05) (Table 3). The amounts of total phospholipid were also increased as compared to the control subjects (p<0.01), but a spot migrating as control paraffin was never seen on TLC.

Table 3—Phospholipid (PL) and Protein Content of BALF from Seven Patients with Liquid Paraffin Pneumonitis, Seven Patients with Pulmonary Alveolar Proteinosis and Tkn Control Subjects

Patients Phospholipids,mg/ml Proteins,mg/ml Phospholipids/Proteins
1 0.10 0.60 0.16
2 0.03 0.22 0.12
3 0.03 0.49 0.06
4 0.02 0.18 0.14
5 0.14 1.89 0.08
6 0.63 0.29 0.11
7 0.05 1.05 0.04
M±SD 0.06 ±0.04 0.67 ±0.61 0.10 ±0.04
PAP (n = 7) 0.13±0.09 5.17 ±4.15 0.03±0.02
Controls 0.03 ±0.02 0.20 ±0.15 0.20 ±0.15
(n = 10)


Figure 4. Thin layer chromatography of lipids extracted from BALF of a patient with liquid paraffin pneumonitis. Left, Solvent system for phospholipid separation (chloroform/methanol/acetic acid/water: 15 + 45 +12 + 6, by vol). The plate was stained by iodine vapor. BALF (2) has an abnormal spot very slightly stained by iodine vapor and migrating as the control liquid paraffin (5). Control sphingomyelin (1), phosphatidylcholine (3), phosphatidylethanolamine (4), phosphatidylserine and phosphatidylinoditol (6), origin (q) and front (f) of migration. B is solvent system for neutral lipid separation (petroleum ether/ diethyl ether/acetic acid: 80 + 20+ 1, by vol). BALF (MC) still has the abnormal spot migrating as control liquid paraffin (p) on the solvent front (f). Control monoglycerides (mg), diglycerides (dg), triglycerides (tg)y free cholesterol (fc), cholesterol ester (ce), and fatty acid (fa).