Prognostic Value off Bronchoalveolar Lavage Lymphocyte Count in Recently Diagnosed Pulmonary Sarcoidosis (1)
Sarcoidosis, a granulomatous disease of unknown etiology, is characterized by an increased number of T-lymphocytes in the lung, more specifically, the helper subset.’ These activated T-lymphocytes may modulate the histologic changes seen in this disease. Immunoglobulin-producing cells are also increased. Alveolar macrophages are activated, secrete angiotensin convertase, and show an enhanced ability to present antigens. The demonstration of such active inflammation raised the question of a possible role of these cells and their mediators in the lung functional impairment seen in this disease. Since the clinical course is variable and the outcome unpredictable, steroid treatment is usually given when significant morphologic and/or functional alterations are present. The availability of an accurate prognostic marker would be useful to identify the patients at risk of deterioration of their lung function and to allow possible early treatment. buy flovent inhaler
Keogh and colleagues showed that subjects with high-intensity lymphocytic alveolitis had a worse prognosis than those with low-intensity lymphocytic alveolitis. However, their study included a small number of subjects who were followed up for a rather short period of time. Other studies looked at the value of lymphocytic alveolitis in predicting the outcome of sarcoidosis” and presented somewhat controversial data. This may, in part, be explained by the heterogeneity of studied populations, which included patients with long-standing or treated sarcoidosis, or racial differences. In this report, we present a prospective study of 98 white patients with newly diagnosed sarcoidosis who were followed up for 6 to 60 months. We looked at the prognostic value of bronchoalveolar lavage (BAL) lymphocyte count obtained at the time of diagnosis of sarcoidosis and its value in the therapeutic decision.