Prognostic Value off Bronchoalveolar Lavage Lymphocyte Count in Recently Diagnosed Pulmonary Sarcoidosis (11)
Recently, Ward et al showed that a high BAL lymphocyte count was found in subjects with acute-onset sarcoidosis, such as that in erythema nodosum and uveitis, entities which have a good prognosis. Therefore, their data, like ours, suggest that a high BAL lymphocyte percentage is not related to lung function impairment. buy birth control online
Our data show that pretreatment BAL lymphocyte count has some predictive value for the therapeutic response to steroid. Hollinger et al studied a group of patients of different races, different duration of disease, and, in some cases, previous steroid treatment. They found a significant correlation between the BAL lymphocyte count and FVC, but not with the other parameters measured. Contrary to Hollinger et al, we do not believe that the BAL lymphocyte count can be clinically useful; the correlation between lymphocyte percentage and pulmonary function presents too much variability and is too weak to be applied to any specific patient.
The presence of a high BAL lymphocyte count at diagnosis was not associated with the need to treat, either at diagnosis or at follow-up. This is similar to what was found in extrinsic allergic alveolitis where also no correlation between the presence of lymphocytic alveolitis and deterioration of lung function was found. In asymptomatic farmers, large numbers of lymphocytes have been found in repeated lavages without evidence of lung function abnormalities or deterioration.* In sarcoidosis, inflammatory cells could be present in the lung without altering lung function, inducing fibrosis and irreversible morphologic changes, and ultimately, predicting an unfavorable outcome.