Prognostic Value off Bronchoalveolar Lavage Lymphocyte Count in Recently Diagnosed Pulmonary Sarcoidosis (10)

Therefore, the study population was more homogeneous than in previous reports. Although histologic confirmation was obtained in only 48 of 98 patients, in the others, the diagnosis of sarcoidosis was strongly supported by the typical clinical presentation and elimination of other diseases by the long follow-up (mean, 25.6 months). We believe it is, therefore, quite unlikely that entities other than sarcoidosis could have been included in the 50 patients without histologic confirmation. Furthermore, subanalysis showed similar results for the nonhistologically proven sarcoidosis compared to the whole group (Fig 1). birth control yasmin
We did not measure the number of BAL T-lympho-cytes but used the total number of lymphocytes for the statistical analysis. Since in sarcoidosis there is an important increase in BAL T-lymphocyte count (90 percent of the total lymphocyte population),2 we used 30 percent as an arbitrary cutoff between high- and low-intensity alveolitis. We believe that this value is similar to that proposed by Keogh et al. We did not obtain a lung gallium scan to further define the high-intensity alveolitis group as proposed by Keogh et al. They found that a patient with a T-lymphocyte count >28 percent rarely (13 percent) had a negative lung gallium scan, but that BAL lymphocyte count alone could not reliably predict functional deterioration. Our study confirms that this criterion cannot identify patients whose condition will deteriorate. Although we included only subjects with recently diagnosed sarcoidosis, interestingly, most patients who required treatment did so at the first visit (18 of 24). Treated patients had a higher incidence of pulmonary infiltrates than nontreated patients, but not a higher incidence of high-intensity lymphocytic alveolitis.

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