Subject(s)
Hyperthermia, Induced , Respiratory Tract Diseases/therapy , Adult , Female , Humans , Male , Middle Aged , SyndromeABSTRACT
To define whether the levels of immunoglobulins and albumin in bronchoalveolar lavage (BAL) fluid are related to the intensity of sarcoidosis alveolitis, 49 patients affected with pulmonary sarcoidosis were studied. To distinguish between high- and low-intensity alveolitis, two parameters were used: the percentage of T lymphocytes and the CD4+/CD8+ ratio in BAL fluid. The results showed an increase of albumin and of the IgG/albumin ratio (p less than 0.05) in patients with high-intensity alveolitis as assessed by both criteria. Moreover, an increase (p less than 0.05) of albumin concentration related to T lymphocyte alveolitis was found. We conclude that: albumin is a reliable index of inflammation; the increase of the IgG/albumin ratio is the expression of local production of IgG as well as of inflammation; the evaluation of albumin and of the IgG/albumin ratio should be useful because they both correlate with the intensity of the alveolitis: the former express inflammatory damage and the latter, immunological activity.
Subject(s)
Albumins/analysis , Bronchoalveolar Lavage Fluid/analysis , Immunoglobulin G/analysis , Lung Diseases/diagnosis , Sarcoidosis/diagnosis , Adult , Antigens, Differentiation, T-Lymphocyte/analysis , Bronchoalveolar Lavage Fluid/cytology , Female , Humans , Immunoglobulin A/analysis , Inflammation , Male , Middle Aged , T-Lymphocytes/classificationABSTRACT
We describe 6 patients with chronic eosinophilic pneumonia (CEP) investigated clinically and by bronchoalveolar lavage (BAL). The BAL findings of these 6 patients were compared with those of 293 patients with other interstitial lung diseases (ILD): 184 with sarcoidosis, 63 with hypersensitivity pneumonitis, 46 with idiopathic pulmonary fibrosis (IPF). In patients with CEP, BAL analysis was characterized by a markedly increased number of eosinophils (mean +/- 1 SD: 54.2 +/- 26.4 of effector cells; in control subjects, eosinophils were less than 1% of effector cells). In patients with other ILD, BAL fluid analysis showed a significant increase in the percentage of eosinophils only in the group of IPF, but in IPF the increased number of eosinophils is linked with a significant increase in the percentage of neutrophils. These findings indicate that besides the classic patterns of lymphocytosis or polymorphonuclear leukocytosis, a predominantly eosinophilic pattern may also be present in the BAL fluid. Moreover, BAL may contribute to understanding the pathogenesis of lung tissue damage in CEP.
