Journal Information
Vol. 41. Issue 8.
Pages 425-429 (August 2005)
Share
Share
Download PDF
More article options
Vol. 41. Issue 8.
Pages 425-429 (August 2005)
Original Articles
Full text access
Radiographic Staging and Bronchoalveolar Lavage Cell Counts in Sarcoidosis
Visits
4131
S. Vidal Serranoa,
Corresponding author
svidals@telefonica.net

Correspondence: Dra. S. Vidal Serrano. Justino de Neve, 5. 41004 Sevilla. España
, J. Martín Juana, L. Gómez Izquierdob, I. Sánchez Rodríguezc, E. Rodríguez Becerraa, F. Rodríguez Panaderoa
a Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
b Departamento de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
c Sección de Neumología, Hospital Juan Ramón Jiménez, Huelva, Spain
This item has received
Article information
Objective

Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology that mainly affects the lungs and lymph nodes. Bronchoalveolar lavage (BAL) is known to be useful in diagnosis of the disease but its value as a prognostic marker is unclear. The aim of this study was to assess whether there is a characteristic pattern in BAL cell counts according to radiographic stage and determine whether BAL offers information on disease course.

Patients and methods

The study included 34 patients with untreated sarcoidosis. Data were collected on the following variables: age, sex, smoking habit, treatment type, radiographic stage, respiratory function, serological parameters, and BAL cell counts. The patients were classified into 3 groups according to functional and radiographic change at 12-month follow-up.

Results

NO differences in age, sex, or smoking habit were found according to either radiographic stage or disease course. Although the proportion of lymphocytes in BAL fluid was higher in radiographic stage I than in stages II and III, the differences were not statistically significant. The differences in BAL cell counts between groups based on disease course were not statistically significant.

Conclusions

NO differences were found in the characteristics of BAL fluid according to radiographic stage. The differential cell count in BAL fluid does not appear to predict the course of sarcoidosis in the first 12 months.

Key Words:
Sarcoidosis
Radiographic stages
Bronchoalveolar lavage
Objetivo

La sarcoidosis es una enfermedad inflamatoria granulomatosa multisistémica de causa desconocida que afecta principalmente al pulmón y a los ganglios linfáticos. La utilidad del lavado broncoalveolar (LBA) en el diagnósti-co es conocida, pero su valor como marcador pronóstico es controvertido. El objetivo de nuestro estudio es evaluar si existe un patrón característico en la celularidad del LBA según el estadio radiológico de presentación y determinar si el LBA aporta información sobre la evolución de la enfermedad.

Pacientes y métodos

Se incluyó en el estudio a 34 pacientes con sarcoidosis no tratados. Se recogieron las siguientes variables: edad, sexo, hábito tabáquico, tipo de tratamiento, estadio radiológico, exploración funcional respiratoria, pará-metros serológicos y análisis celular del LBA. Se clasificó a los pacientes en 3 grupos según la evolución funcional y radioló-gica a los 12 meses.

Resultados

NO se encontraron diferencias entre la edad, el sexo y el hábito tabáquico ni entre los estadios radiológicos ni entre los grupos según evolución. En el estadio radiológico I el recuento porcentual de linfocitos del LBA fue mayor que en los estadios II y III, pero las diferencias no fueron estadís-ticamente significativas. Las diferencias en el LBA por grupos evolutivos no fueron estadísticamente significativas.

Conclusiones

Al analizar las características del LBA según estadios radiológicos no se encontraron diferencias. El recuento diferencial de células en el LBA no parece predecir el curso de la sarcoidosis durante los primeros 12 meses.

Palabras clave:
Sarcoidosis
Estadios radiológicos
Lavado broncoalveolar
Full text is only aviable in PDF
REFERENCES
[1]
LS Newman, CS Rose, LA Maier.
Sarcoidosis.
N Engl J Med, 336 (1997), pp. 1224-1234
[2]
LE Siltzbach.
Sarcoidosis: clinical features and management.
Med Clin North Am, 51 (1967), pp. 483-502
[3]
M Remy-Jardin, F Giraud, J Remy, L Wattinne, B Wallaert, A Duhamel.
Pulmonary sarcoidosis: role of CT in the evaluation of disease activity and functional impairment and in prognosis assessment.
Radiology, 191 (1994), pp. 675-680
[4]
BA Keogh, GW Hunninghake, BR Line, RG Crystal.
The alveolitis of pulmonary sarcoidosis: evaluation of natural history and alveolitis-dependent changes in lung function.
Am Rev Respir Dis, 128 (1983), pp. 256-265
[5]
NM Foley, AP Coral, K Tung, BN Hudspith, DG James, N McJohnson.
Bronchoalveolar lavage cell counts as predictor of short term outcome in pulmonary sarcoidosis.
Thorax, 44 (1989), pp. 472-538
[6]
S Buchalter, W App, L Jackson, D Chandler, R Jackson, J Fulmer.
Bronchoalveolar lavage cell analysis in sarcoidosis: a comparison of lymphocyte counts and clinical course.
Ann N Y Acad Sci, 465 (1986), pp. 678-684
[7]
U Costabel, KJ Bross, J Guzman, A Nilles, KH Rühle, H Matiz.
Predictive value of bronchoalveolar T cell subsets for the course of pulmonary sarcoidosis.
Ann N Y Acad Sci, 465 (1986), pp. 418-426
[8]
MW Ziegenhagen, UK Benner, G Zissel, P Zabel, M Schlaak, J Müller-Quernheim.
Sarcoidosis: TNF-alpha release from alveolar macrophages and serum level of SIL-2R are prognostic markers.
Am J Respir Crit Care Med, 156 (1997), pp. 1586-1592
[9]
MW Ziegenhagen, ME Rothe, M Schlaak, J Müller-Quernheim.
Bronchoalveolar and serological parameters reflecting the severity of sarcoidosis.
Eur Respir J, 21 (2003), pp. 407-413
[10]
A Xaubet, J Ancochea, R Blanquer, C Montero, F Morell, E Rodríguez Becerra, et al.
Diagnóstico y tratamiento de las enfermedades pulmonares intersticiales difusas.
Arch Bronconeumol, 39 (2003), pp. 580-600
[11]
GW Hunninghake, S Gilbert, R Pueringer, C Dayton, C Floerchinger, R Helmers, et al.
Outcome of the treatment of sarcoidosis.
Am J Respir Crit Care Med, 149 (1994), pp. 893-898
[12]
DA Mahler, DH Weinberg, CK Wells, AR Feinstein.
The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes.
Chest, 85 (1984), pp. 751-758
[13]
J Sanchís, P Casán, J Castillo, N González, L Palenciano, J Roca.
Normativa para la práctica de la espirometría forzada.
Arch Bronconeumol, 25 (1989), pp. 132-142
[14]
J Castella, J Ancochea, L Llorente, C Puzo, J Sanchís, A Sueiro, et al.
Normativa SEPAR: lavado broncoalveolar.
Arch Bronconeumol, 33 (1997), pp. 515-526
[15]
J Martín Juan, F Valenzuela Mateos, G Soto Campos, A Segado Soriano, F Rodríguez Panadero, J Gómez Castillo.
Estudio de calidad y selección de muestras de lavado broncoalveolar (LBA) en neumopatías difusas.
Arch Bronconeumol, 32 (1996), pp. 332-340
[16]
American Thoracic Society.
Bronchoalveolar lavage constituents in healthy individuals, idiopathic pulmonary fibrosis, and selected comparison groups.
Am Rev Respir Dis, 141 (1990), pp. 167-202
[17]
Statement on sarcoidosis.
Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999.
Am J Respir Crit Care Med, 160 (1999), pp. 736-755
[18]
AD Tahanovich, IL Katovich, HL Baradzina.
Evaluation of bronchoalveolar lavage fluid phospholipids and cytokine release by alveolar macrophages as prognostic markers in sarcoidosis.
Respiration, (2003), pp. 376-381
[19]
M Laviolette, J la Forge, S Tennina, L-P Boulet.
Prognostic value of bronchoalveolar lavage lymphocyte count in recently diagnosed pulmonary sarcoidosis.
Chest, 100 (1991), pp. 380-384
[20]
M Drent, JA Jacobs, J de Vries, RJ Lamers, IH Liem, EF Wouters.
Does the cellular bronchoalveolar lavage fluid profile reflect the severity of sarcoidosis?.
Eur Resp J, 13 (1999), pp. 1338-1344
[21]
YH Lin, PL Haslam, M Turner-Warwick.
Chronic pulmonary sarcoidosis: relationship between lung lavage cell counts, chest radiograph, and results of standard lung function tests.
Thorax, 40 (1985), pp. 501-507
[22]
K Ward, C O'Connor, C Odlum, MX Fitzgerald.
Prognostic value of bronchoalveolar lavage in sarcoidosis: the clinical influence of disease presentation.
Thorax, 44 (1989), pp. 6-12
[23]
L Welker, RA Jörres, U Costabel, H Magnussen.
Predictive value of BAL cell differentials in the diagnosis of interstitial lung diseases.
Eur Respir J, 24 (2004), pp. 1000-1006
Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?