Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis

Yıl: 2020 Cilt: 21 Sayı: 1 Sayfa Aralığı: 21 - 26 Metin Dili: İngilizce DOI: 10.5152/TurkThoracJ.2018.180140 İndeks Tarihi: 11-12-2020

Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis

Öz:
OBJECTIVES: The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with awide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis isaltered by clinicoradiological findings of patients with sarcoidosis.MATERIALS AND METHODS: The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatientclinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in thestudy. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis wererecorded. According to the diagnostic performance, the BALF results were grouped as “diagnostic” and “non-diagnostic,” and recordedparameters were compared between the groups.RESULTS: Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5–80), and the mean CD4/CD8was 5.5±4.7 (0.1–24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did notcorrelate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomographyscoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006).CONCLUSION: BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients withextrapulmonary involvement.
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  • 1. American Thoracic Society/European Respiratory Society/ World Association Sarcoidosis and Other Granulomatous Disorders. Statement on Sarcoidosis. Am J Respir Crit Care Med 1999;160:736-55. [CrossRef]
  • 2. Baughman RP, Lower EE, du Bois RM. Sarcoidosis. Lancet 2003;361:1111-8. [CrossRef]
  • 3. Costabel U. CD4/CD8 ratios in bronchoalveolar lavage fluid: of value for diagnosing sarcoidosis? Eur Respir J 1997;10:2699- 700. [CrossRef]
  • 4. Hyldgaard C, Kaae S, Riddervold M, et al. Value of s-ACE, BAL lymphocytosis, and CD4+/CD8+ and CD103+CD4+/CD4+ Tcell ratios in diagnosis of sarcoidosis. Eur Respir J 2012;39:1037- 9. [CrossRef]
  • 5. Shen Y, Pang C, Wu Y, et al. Diagnostic performance of bronchoalveolar lavage fluid CD4/CD8 ratio for sarcoidosis: A metaanalysis. EBioMedicine 2016;8:302-8. [CrossRef]
  • 6. Marruchella A., Tondini M. Reliability of bronchoalveolar lavage in the routine clinical assessment of patients with sarcoidosis. A retrospective analysis. Panminerva Med 2002;44:257- 60.
  • 7. Greco S, Marruchella A, Massari M, Saltini C. Predictive value of BAL cellular analysis in differentiating pulmonary tuberculosis and sarcoidosis. Eur Respir J 2005;26:360-1. [CrossRef]
  • 8. Lee W, Chung WS, Hong KS, Huh J. Clinical usefulness of bronchoalveolar lavage cellular analysis and lymphocyte subsets in diffuse interstitial lung diseases. Ann Lab Med 2015;35:220-5. [CrossRef]
  • 9. Urbankowski T, Knyziak-Medrzycka I, Domagała-Kulawik J, Chazan R. Sarcoidosis and tobacco smoking--clinical picture, diagnostic tests results and bronchoalveolar lavage fluid composition. Pol Merkur Lekarski 2012;32:298-301.
  • 10. Hoser G, Kawiak J, Domagała-Kulawik J, et al. Flow cytometric evaluation of lymphocyte subpopulations in BALF of healthy smokers and nonsmokers. Folia Histochem Cytobiol 1999;37:25-30.
  • 11. Danila E, Jurgauskiene L, Malickaite R. BAL fluid cells and pulmonary function in different radiographic stages of newly diagnosed sarcoidosis. Adv Med Sci 2008;53:228-33. [CrossRef]
  • 12. Danila E, Jurgauskiene L, Norkuniene J, Malickaite R. BAL fluid cells in newly diagnosed pulmonary sarcoidosis with different clinical activity. Ups J Med Sci 2009;114:26-31. [CrossRef]
  • 13. Costabel U, Guzman J. Bronchoalveolar lavage in interstitial lung disease. Curr Opin Pulm Med 2001;7:255-61. [CrossRef]
  • 14. Meyer KC, Raghu G, Baughman RP, et al. An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med 2012;185:1004-14. [CrossRef]
  • 15. Baughman RP, Culver DA, Judson MA. A Concise Review of Pulmonary Sarcoidosis. Am J Respir Crit Care Med 2011 1;183:573-81. [CrossRef]
  • 16. Scadding JG. Prognosis of intrathoracic sarcoidosis in England. BMJ 1961;4:1165-72. [CrossRef]
  • 17. Oberstein A, Zitzewitz H von, Schweden F, Müller-Quernheim J. Non-invasive evaluation of the inflammatory activity in sarcoidosis with high-resolution computed tomography. Sarcoidosis Vasc Diffuse Lung Dis 1997;14:65-72.
  • 18. Efared B, Ebang-Atsame G, Rabiou S, et al. The diagnostic value of the bronchoalveolar lavage in interstitial lung diseases. J Negat Results Biomed 2017;16:4. [CrossRef]
  • 19. Kiter G, Musellim B, Cetinkaya E, et al. Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tuberk Toraks 2011;59:248-58. [CrossRef]
  • 20. Cardosa AV, Mota PC, Melo N, et al. Analysis of sarcoidosis in the Oporto region (Portugal). Rev Port Pneumol 2017;23:251-8. [CrossRef]
  • 21. Bronchoalveolar lavage constituents in healthy individuals, idiopathic pulmonary fibrosis, and selected comparison groups. The BAL Cooperative Group Steering. Am Rev Respir Dis 1990;141:S169-202.
  • 22. Valeyre D, Soler P, Clerici C, et al. Smoking and pulmonary sarcoidosis: effect of cigarette smoking on prevalence, clinical manifestations, alveolitis, and evolution of the disease. Thorax 1988;43:516-24. [CrossRef]
  • 23. Meyer KC, Raghu G. Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful? Eur Respir J 2011;38:761-9. [CrossRef]
  • 24. Heron M, Grutters JC, ten Dam-Molenkamp KM, et al. Bronchoalveolar lavage cell pattern from healthy human lung. Clin Exp Immunol 2012;167:523-31. [CrossRef]
  • 25. Aleksonienè R, Zeleckienè I, Matačiūnas M, et al. Relationship between radiologic patterns, pulmonary function values and bronchoalveolar lavage fluid cells in newly diagnosed sarcoidosis. J Thorac Dis 2017;9:88-95. [CrossRef]
  • 26. Kebbe J, Abdo T. Interstitial lung disease: the diagnostic role of bronchoscopy. J Thorac Dis 2017;9(Suppl 10):S996-S1010. [CrossRef]
  • 27. Inomata T, Konno S, Nagai K, et al. Neutrophil predominance in bronchoalveolar lavage fluid is associated with disease severity and progression of HRCT findings in pulmonary Mycobacterium avium infection. Plos One 2018;13:e0190189. [CrossRef]
  • 28. Okumus G, Musellim B, Cetinkaya E, et al. Extrapulmonary involvement in patients with sarcoidosis in Turkey. Respirology 2011;16:446-50. [CrossRef]
  • 29. Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-9.[CrossRef]
APA Tokgoz Akyil F, Ağca M, Akay H, Sonkaya E, Erdem I, Usta Bülbül E, Özbaki F, Yıldız R, Alparslan Bekir S, SEVİM s (2020). Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. , 21 - 26. 10.5152/TurkThoracJ.2018.180140
Chicago Tokgoz Akyil Fatma,Ağca Meltem,Akay Hatice,Sonkaya Esin,Erdem Ipek,Usta Bülbül Esra,Özbaki Fatma,Yıldız Reyhan,Alparslan Bekir Sumeyye,SEVİM sevim Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. (2020): 21 - 26. 10.5152/TurkThoracJ.2018.180140
MLA Tokgoz Akyil Fatma,Ağca Meltem,Akay Hatice,Sonkaya Esin,Erdem Ipek,Usta Bülbül Esra,Özbaki Fatma,Yıldız Reyhan,Alparslan Bekir Sumeyye,SEVİM sevim Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. , 2020, ss.21 - 26. 10.5152/TurkThoracJ.2018.180140
AMA Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. . 2020; 21 - 26. 10.5152/TurkThoracJ.2018.180140
Vancouver Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. . 2020; 21 - 26. 10.5152/TurkThoracJ.2018.180140
IEEE Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s "Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis." , ss.21 - 26, 2020. 10.5152/TurkThoracJ.2018.180140
ISNAD Tokgoz Akyil, Fatma vd. "Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis". (2020), 21-26. https://doi.org/10.5152/TurkThoracJ.2018.180140
APA Tokgoz Akyil F, Ağca M, Akay H, Sonkaya E, Erdem I, Usta Bülbül E, Özbaki F, Yıldız R, Alparslan Bekir S, SEVİM s (2020). Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turkish Thoracic Journal, 21(1), 21 - 26. 10.5152/TurkThoracJ.2018.180140
Chicago Tokgoz Akyil Fatma,Ağca Meltem,Akay Hatice,Sonkaya Esin,Erdem Ipek,Usta Bülbül Esra,Özbaki Fatma,Yıldız Reyhan,Alparslan Bekir Sumeyye,SEVİM sevim Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turkish Thoracic Journal 21, no.1 (2020): 21 - 26. 10.5152/TurkThoracJ.2018.180140
MLA Tokgoz Akyil Fatma,Ağca Meltem,Akay Hatice,Sonkaya Esin,Erdem Ipek,Usta Bülbül Esra,Özbaki Fatma,Yıldız Reyhan,Alparslan Bekir Sumeyye,SEVİM sevim Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turkish Thoracic Journal, vol.21, no.1, 2020, ss.21 - 26. 10.5152/TurkThoracJ.2018.180140
AMA Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turkish Thoracic Journal. 2020; 21(1): 21 - 26. 10.5152/TurkThoracJ.2018.180140
Vancouver Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turkish Thoracic Journal. 2020; 21(1): 21 - 26. 10.5152/TurkThoracJ.2018.180140
IEEE Tokgoz Akyil F,Ağca M,Akay H,Sonkaya E,Erdem I,Usta Bülbül E,Özbaki F,Yıldız R,Alparslan Bekir S,SEVİM s "Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis." Turkish Thoracic Journal, 21, ss.21 - 26, 2020. 10.5152/TurkThoracJ.2018.180140
ISNAD Tokgoz Akyil, Fatma vd. "Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis". Turkish Thoracic Journal 21/1 (2020), 21-26. https://doi.org/10.5152/TurkThoracJ.2018.180140