We also evaluated whether the responsiveness to steroid treatment could be predicted by the percentage of BAL lymphocytes. The difference in the pulmonary functions before and during steroid treatment (mean duration of treatment, 3.5 months) were correlated to BAL lymphocyte counts. Weak but significant correlations were found between the lymphocyte count and AFEVj (r=0.41, p=0.031) and AFVC (r=0.36, p=0.05) (Fig 2). The ATLC, AFRC, ADco, and ADco/VA values did not correlate with BAL lymphocyte counts (r = 0.33, r = 0.18, r=0.04, and r=0.30, respectively).
In this prospective study, we show that BAL lymphocyte count at diagnosis is not a valuable prognostic factor in patients with newly diagnosed sarcoidosis. Patients who needed treatment had a BAL lymphocyte percentage similar to that of those who did not; therefore, BAL lymphocyte count was not useful in the clinical decision to treat. In patients who required treatment, the BAL lymphocyte count weakly predicted response. flovent inhaler
In comparison with other reports,” this study has a large number of untreated patients, all with newly diagnosed sarcoidosis and a long follow-up. Our observations do not include patients with long-standing sarcoidosis and previous physiologic changes or treatment. Moreover, all our subjects were white.
Figure 2. Correlation between pretreatment BAL lymphocyte percentages and the variation of FEVj and FVC (AFEVi and AFVC) with treatment in the 22 patients who received steroids. The improvements in both pulmonary function parameters showed a weak but significant correlation with lymphocyte count.