Journal article
Bronchoalveolar lavage quality influences the T4/T8 ratio in sarcoidosis.
- Reichenberger F Pulmonary Medicine, University Hospital Basel, Switzerland. Frank.Reichenberger@innere.med.uni-giessen.de
- Kleiber B
- Baschiera B
- Bubendorf L
- Brutsche M
- Dalquen P
- Tamm M
- 2007-06-26
Published in:
- Respiratory medicine. - 2007
Bronchoalveolar Lavage
Bronchoalveolar Lavage Fluid
CD4-CD8 Ratio
Cell Count
Cilia
Female
Humans
Lymphocyte Count
Male
Mucus
Prospective Studies
Sarcoidosis, Pulmonary
Sodium Chloride
Specimen Handling
T-Lymphocyte Subsets
English
BACKGROUND
Sarcoidosis is characterised by a T-lymphocytic alveolitis with a typically increased T4/T8 ratio. The diagnostic value of this ratio is under debate.
AIM OF THE WORK
We prospectively evaluated the influence of BAL pre-lavage and the impact of bronchial contamination on BAL differential cell count in 108 BAL specimens obtained from patients with histologically confirmed sarcoidosis.
METHODS
BAL was performed by instilling 150-300 ml normal saline either in the middle lobe or the lingula. Fifty-one patients (47%) underwent additional pre-lavage with 50 ml normal saline. Bronchial contamination was assessed by semi-quantitative analysis of mucus, ciliated and squamous cells in the untreated BAL recovery.
RESULTS
Pre-lavage did neither influence the lavage cellularity nor extend of contamination of the BAL. Content of mucus and ciliated cells, indicating bronchial contamination, showed a high correlation (Kendal's tau=0.61). Presence of either mucus or ciliated cells in the BAL recovery was associated with a significant lower T4/T8 ratio (mucus: 4.9 vs. 8.0, p=0.009; ciliated cells: 4.1 vs. 7.4, p=0.001). Squamous cells in the BAL recovery representing oropharyngeal contamination did not significantly influence the T4/T8 ratio (7.7 vs. 5.6, p=0.10).
CONCLUSION
Bronchial contamination of BAL as determined by the presence of mucus and ciliated cells in the recovery decreases the T4/T8 ratio of BAL in sarcoidosis.
Sarcoidosis is characterised by a T-lymphocytic alveolitis with a typically increased T4/T8 ratio. The diagnostic value of this ratio is under debate.
AIM OF THE WORK
We prospectively evaluated the influence of BAL pre-lavage and the impact of bronchial contamination on BAL differential cell count in 108 BAL specimens obtained from patients with histologically confirmed sarcoidosis.
METHODS
BAL was performed by instilling 150-300 ml normal saline either in the middle lobe or the lingula. Fifty-one patients (47%) underwent additional pre-lavage with 50 ml normal saline. Bronchial contamination was assessed by semi-quantitative analysis of mucus, ciliated and squamous cells in the untreated BAL recovery.
RESULTS
Pre-lavage did neither influence the lavage cellularity nor extend of contamination of the BAL. Content of mucus and ciliated cells, indicating bronchial contamination, showed a high correlation (Kendal's tau=0.61). Presence of either mucus or ciliated cells in the BAL recovery was associated with a significant lower T4/T8 ratio (mucus: 4.9 vs. 8.0, p=0.009; ciliated cells: 4.1 vs. 7.4, p=0.001). Squamous cells in the BAL recovery representing oropharyngeal contamination did not significantly influence the T4/T8 ratio (7.7 vs. 5.6, p=0.10).
CONCLUSION
Bronchial contamination of BAL as determined by the presence of mucus and ciliated cells in the recovery decreases the T4/T8 ratio of BAL in sarcoidosis.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.rmed.2006.11.027
- PMID 17587560
- Persistent URL
- https://sonar.ch/global/documents/97957
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