Analysis of Sarcoidosis by Bronchoalveolar Lavage Fluid

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The relationship between clinical manifestations and bronchoalveolar lavage fluid (BALF) findings was studied in 186 patients (70 males and 116 females) with histologicarlly-confirmed sarcoidosis treated between 1977 and 1993. BALF was obtained from 142 patients at the time of diagnosis, and the mean lymphocyte count was 31±20 (n=142) and CD4^+/CD8^+ ratio was 4.8±3.8 (n=98). The patients were grouped by age into those in their twenties, fifties, and over sixty ; the CD4^+/CD8^+ ratio was 3.8±2.4 (n=35), 5.2±3.7 (n=23), and 6.0±5.4 (n=21), respectively. Data for patients who were not treated with steroids (n=106) were further analyzed, and a significant positive correlation was found between sustained elevation of angiotensin-converting enzyme and the age at diagnosis (p<0.05). There was a significant correlation between improvement of bilateral hilar lymphadenopathy and low CD4^+/CD8^+ ratio at the time of diagnosis (p<0.05), while the change of pulmonary infiltration was not correlated with the CD4^+/CD8^+ ratio. These results suggest that the age at diagnosis and the initial value of the CD4^+/CD8^+ ratio in BALF may be useful in the prediction of the likelihood of sustained sarcoidosis activity during the clinical course.