Changes in bronchoalveolar lavage and lung function in rheumatoid arthritis. A controlled study.

A comparative study of bronchoalveolar lavage was done in 30 patients with chronic rheumatoid arthritis and 30 age matched controls. Twelve patients had clinical lung disease (group I), 11 had lavage changes (group II) and 7 showed no abnormalities (group III). In group I, there was lower lung functions, tendency to older age and slightly longer history. There were no differences between the three groups (63% positive) in RA factor positivity. In the controls, lavage showed 67.3% return, 154.5 cells/cmm, 92.8% macrophages, 5.2% lymphocytes, 1.9% polymorphs and 0.2% eosinophils. In contrast, group I patients showed more polymorphs (10.3 +/- 8.3%) and group II more lymphocytes (14.5 +/- 18.7%; P less than 0.05). Thus, in chronic rheumatoid arthritic patients, bronchoalveolar lavage abnormalities may occur alone or in association with radiographic and functional abnormalities.

Value of bronchoalveolar lavage in interstitial lung diseases.

Fifty-eight patients of interstitial lung diseases and 30 control patients were submitted to bronchoalveolar lavage (BAL) with flexible fibreoptic bronchoscopy. In 30 controls (with fluid recovery 61.7%) total cell count was 175 +/- 31/mm3 with macrophages 87.5 +/- 2.0%, neutrophils 7 +/- 1.9 and lymphocytes 5 +/- 0.6%. In idiopathic interstitial fibrosis (34 cases) these values were respectively 832 +/- 221/mm3, 47 +/- 5.5, 29 +/- 5.0 and 19 +/- 5 percent (significantly different P: less than 0.005, 0.001, 0.1 and 0.005 respectively from control. The results of bilateral lavages in 28 interstitial cases were similar. In other categories viz: sarcoidosis(8), macrophages were significantly fewer (61 +/- 10%: P less than 0.05) and lymphocytes significantly more (27 +/- 6.4%: P less than 0.05); in rheumatoid lung disease (4 cases) significantly fewer macrophages (45 +/- 5) were seen and 12 cases with methyl isocyanate exposure showed insignificant changes.