Japanese Journal of Medicine
Online ISSN : 1881-123X
Print ISSN : 0021-5120
Bronchoalveolar Lavage Studies in Uveitis Patients without Radiological Intrathoracic Involvement of Sarcoidosis
Mineharu SUGIMOTOHironori NAKASHIMAMasayuki ANDOHirotsugu KOHROGIShukuro ARAKI
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JOURNAL FREE ACCESS

1989 Volume 28 Issue 1 Pages 50-54

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Abstract

In the present study, we investigated thirty uveitis patients who had a possible diagnosis of ocular sarcoidosis, no respiratory symptoms, and normal chest X-rays, in order to determine whether bronchoalveolar lavage was useful for establishing a diagnosis of subclinical pulmonary involvement of sarcoidosis. Sixteen of 30 uveitis patients showed bronchoalveolar lymphocytosis (39±11%) as compared to normal controls (14±3%). Ten of these 16 patients were associated with significantly increased proportions of CD3+ cells with elevated CD4+/CD8+ ratios (P<0.01). These data were consistent with those of patients with active pulmonary sarcoidosis (stage 1 and 2) except for total cell count in lavage fluid, but different from those of patients with hypersensitivity pneumonitis. Transbronchial lung biopsy showed noncaseating epithelioid cell granuloma in 4 of 10 uveitis patients with bronchoalveolar T-lymphocytosis and increased CD4+/CD8+ ratios. Immunohistochemical studies of biopsied lung tissues showed many CD3+ cells and CD4+ cells with very few CD8+ cells in the granuloma. These results suggest that T-lymphocytosis with elevated CD4+/CD8+ratios in bronchoalveolar lavage fluid could be a good marker in predicting the pulmonary involvement of sarcoidosis in patients with suspected ocular sarcoidosis and normal chest X-rays.

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© The Japanese Society of Internal Medicine
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