BAL Fluid Cells and Pulmonary Function in Different Radiographic Stages of Newly Diagnosed Sarcoidosis

Purpose: Sarcoidosis affected lungs detected in more than 90% of patients. The relationship between different stages of pulmonary sarcoidosis and pulmonary function tests (PFT) as well as bronchoalveolar lavage fluid (BALF) cells can be established. Geographic and ethnic factors are known to be linked to the specific characteristics of patients with sarcoidosis. The purpose of the study was to evaluate peculiarities of BALF cells pattern and pulmonary function tests at the time of the diagnosis of different radiographic types of sarcoidosis in a large group of Lithuanian sarcoid patients.

Material And Methods: This is the prospective study of BALF cells and PFT of patients with newly diagnosed sarcoidosis. The study population consisted of 221 non-treated non-smoker patients. All patients underwent BAL and the majority of them underwent PFT.

Results: Comparing Stage I to Stage III groups, a slight increase in the macrophage and neutrophil count and a decrease of lymphocyte count was apparent. However, the leukocyte population difference was not statistically significant. We have observed significant increase of CD8 cell count, as well as a decrease of both the CD4 cell count and the CD4/CD8 ratio from Stage I to Stage III. We have determined statistically significant differences in all PFT parameters among the patient groups with different radiographic stages of sarcoidosis. The values of FVC, VC and TLC tended to decrease with an elevation of BALF neutrophils and/or eosinophils count. However BALF cells did not correlate well with PFT indices.

Conclusions: In newly diagnosed sarcoid patients, BALF cell and PFT markers depend on the sarcoidosis stage.