Prognostic Value off Bronchoalveolar Lavage Lymphocyte Count in Recently Diagnosed Pulmonary Sarcoidosis (6)

Table 1 summarizes the results of pulmonary function testing and the BAL parameters of the studied subjects at time of diagnosis. The mean values of the pulmonary function tests for the group were normal. The BAL cell determinations showed an increased number of cells (mean, 18.7 x lOVml) and an increased lymphocyte count (mean: 29.7 percent) compared to normal volunteers studied in our laboratory over the same period (5.8 X lOVml and 9.6 percent, respectively). Very few neutrophils and eosinophils were found. No correlation was found between BAL lymphocyte count and roentgenographic staging.
A total of 24 patients (10 men and 14 women) fulfilled the treatment criteria chosen for this study: 18 at the first visit and two before and four after the first six-month follow-up. Reasons for treating were as follows: decreased lung volumes in 21 patients, decreased lung volumes associated with persistent symptoms in one, decreased lung volumes and myocardial involvement in one, and low Deo and significant hypoxemia in one. Seven patients received prednisone every other day starting with 40 mg for three months, and 15 were placed on a daily regimen beginning with 50 mg per day; steroids were then progressively tapered. In two patients, steroids were postponed because of concomitant medical conditions (severe diabetes and cardiac disease).

Table 1—Pulmonary Function and BAL Barometers at the Time of Diagnosis

No. Mean Range
TLC* 97 95.3 69-128
FRC* 97 102.2 56-159
FVC* 98 90.6 48-122
FEVj* 98 86.3 42-125
DLco* 96 88.7 49-155
Total number of cells (X lOVml) 98 18.7 0.7-66.4
Macrophages, % 98 68.5 12.0-97.5
Lymphocytes, % 98 29.7 2.0-85.5
Neutrophils, % 98 1.5 0.0-14.0
Eosinophils, % 98 0.3 0.0-4.0
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