Relationship between radiologic patterns, pulmonary function values and BALF cells in newly diagnosed sarcoidosis

Abstract

Aim of the study: To evaluate interface between radiologic changes, pulmonary function impairment and bronchoalveolar lavage fluid (BALF) cells in sarcoidosis patients. Materials and methods: 80 patients with newly diagnosed sarcoidosis (41 F, 39 M, age 39±9 yrs) were included. Patients underwent CT scanning, pulmonary function tests (PFT) and BAL. Correlations between CT patterns, PFT values and BALF cells were analysed. Results: Statistically significant differences between FVC (p=0.040), FEV1 (p=0.017), TLC (p=0.049), VC (p=0.015), DLCO (p=0.012) and BALF neutrophil count (p=0.02) were found in different radiographic stages of sarcoidosis. PFT values were decreased in stage III compared with stage I patients. Correlations between consolidation, ground glass opacities on CT and FVC (r=-2.227, p=0.043), FEV1 (r=-0.299, p=0.007), FEV1/FVC (r=-0.245, p=0.029), DLCO (r=-267, p=0.017) were established. Micronodules, macronodules and linear opacities didn9t correlate with PFT values or BALF cell count. There was a negative correlation between lymph nodes calcinosis and FEV1 (p=0.004). In cases of atypical lymphadenopathy BALF neutrophil count tended to be increased. BALF lymphocytes elevation (r=-0.272, p=0.020), decrease of macrophage count (r=0.271, p=0.020) was associated with decreased TLC values. Typical lymphadenopathy localization was associated with increase of CD4/CD8 ratio. CD8 (p=0.005) increase, CD4 (p=0.035) and the CD4/CD8 ratio (p=0.011) decrease was found in smoking patients compared with non-smokers in stage II. Conclusions: A strong interface between radiologic changes, pulmonary function impairment and BALF cells exists in sarcoidosis patients.