Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful?

Meyer, Keith C.; Raghu, Ganesh

doi:10.1183/09031936.00069509

Cited by 117 publications

(106 citation statements)

References 73 publications

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“…World scientific literature represents a range of studies which demonstrate clear correlation between the concentration of soluble IL-2 receptor and T-helpers. The increase of soluble IL-2 receptor level in peripheral blood serum is an activity marker in patients with sarcoidosis of respiratory organs and extrathoracic damages (except Lofgren's syndrome) [10,11].…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

Ostrovskyy

Shvets

2017

Arch. clin. med.

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This research work is devoted to the development of new additional criteria for the activity of inflammatory process in sarcoidosis of respiratory organs. The objective is to assess the effectiveness of performed treatment of sarcoidosis of respiratory organs by using low-cost highly-sensitive inflammatory markers. Materials and methods. The study involved 68 patients with lung sarcoidosis before and after the three-month treatment. In addition to general-clinical methods of examination, patients with sarcoidosis were also determined the levels of TNF-α and CRP. Results and their discussion. Patients with active lung sarcoidosis had 17.6 times (p<0.05) increased level of CRP in bronchoalveolar lavage fluid and 9.0 times (p<0.05) increased levels in peripheral blood serum; the levels of TNF-α increased by 4.98 times (p<0.05) in bronchoalveolar lavage fluid and by 3.2 times (p<0.05) in peripheral blood serum as compared to the findings in the control group of patients. The study showed that in the group of patients, where the efficacy of the prescribed therapy was noted, the level of CRP decreased by 2.76 times (p<0.05) in bronchoalveolar lavage fluid and by 2.58 times (p<0.05) in peripheral blood serum, and the concentration of TNF-α decreased by 3.87 times (p<0.05) in bronchoalveolar lavage fluid and by 2.06 times in peripheral blood serum as compared to the initial indices. Conclusions. The decrease of TNF-α level in bronchoalveolar lavage fluid on the background of three-months treatment correlated (r=0.89; p<0.05) to the changes in peripheral blood serum; at the same time the decrease of TNF-α level in peripheral blood serum correlated (r=0.82; p<0.05) to the decrease of CRP in peripheral blood serum of patients with sarcoidosis of respiratory organs.

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Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

Ostrovskyy

Shvets

2017

Arch. clin. med.

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“…A BAL is most important and most likely to aid in diagnosis in cases of diseases that present with ground-glass opacities, consolidations, and nodules on HRCT, such as sarcoidosis, hypersensitivity pneumonitis (HP), pulmonary alveolar proteinosis (PAP), alveolar hemorrhage, acute diffuse lung disease, eosinophilic lung disease, and infection. (14,15) Regarding biopsies, the ILD guidelines emphasize that the decision of whether to perform TBB or surgical biopsy in ILD patients should take into account the clinical evaluation, including patient age, occupational history, and functional status, as well as the location and CT features of the lesions. The yield of TBB is higher than is that of BAL in cases of diseases that present with ground-glass opacities, consolidations, including ventilatory, cardiovascular, and peripheral factors.…”

Section: Classification Of Ildsmentioning

confidence: 99%

Destaques das diretrizes de doenças pulmonares intersticiais da Sociedade Brasileira de Pneumologia e Tisiologia

et al. 2012

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Interstitial lung diseases (ILDs) are heterogeneous disorders, involving a large number of conditions, the approach to which continues to pose an enormous challenge for pulmonologists. The 2012 Brazilian Thoracic Association ILD Guidelines were established in order to provide Brazilian pulmonologists with an instrument that can facilitate the management of patients with ILDs, standardizing the criteria used for the diagnosis of different conditions and offering guidance on the best treatment in various situations. The objective of this article was to briefly describe the highlights of those guidelines.Keywords: Lung diseases, interstitial; Guidelines as topic; Brazil. ResumoAs doenças pulmonares intersticiais (DPIs) são afecções heterogêneas, envolvendo um elevado número de condições, cuja abordagem ainda é um grande desafio para o pneumologista. As Diretrizes de DPIs da Sociedade Brasileira de Pneumologia e Tisiologia, publicadas em 2012, foram estabelecidas com o intuito de fornecer aos pneumologistas brasileiros um instrumento que possa facilitar a abordagem dos pacientes com DPIs, padronizando-se os critérios utilizados para a definição diagnóstica das diferentes condições, além de orientar sobre o melhor tratamento nas diferentes situações. Esse artigo teve como objetivo descrever resumidamente os principais destaques dessas diretrizes.Descritores: Doenças pulmonares intersticiais; Guias como assunto; Brasil.

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“…In diseases such as sarcoidosis, HP and IIPs, diagnosis cannot be made without integration of HRCT data [69,70]. It should be stressed though, that when HRCT findings are atypical for either sarcoidosis or HP, an absence of BAL lymphocytosis may exclude these disorders.…”

Section: Is Bal Useful In the Diagnosis And Management Of Ilds?mentioning

confidence: 99%

Recent advances in the pathogenesis and clinical evaluation of pulmonary fibrosis

Margaritopoulos¹,

Romagnoli²,

Poletti³

et al. 2012

European Respiratory Review

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Interstitial lung diseases (ILDs) are a group of heterogeneous disorders, either idiopathic or associated with injurious or inflammatory causes, in which the major site of damage is the lung interstitium. For a long time, knowledge regarding pathogenesis was trivial and there were difficulties in diagnosing and subsequently treating these diseases.During the past decade, however, there has been an impressive development in the field of ILDs. Idiopathic pulmonary fibrosis, the most common and fatal form of ILD, was initially believed to be due to an inflammatory response to unknown lung injury, whereas nowadays it is believed to be the result of multiple injuries at different sites of the lung followed by aberrant repair.The integration of clinical, radiological and histological data, namely a multidisciplinary team (MDT) approach, has provided grounds for a more accurate diagnosis of ILDs, and helped the identification of different entities and development of different therapeutic approaches. However, because of the complexity of ILDs, even this approach may fail to establish a confident diagnosis.How should the clinician behave in this case and what are the pitfalls of the MDT approach? In addition, since diagnosis is the major predictor of prognosis, are there any other tools available to predict prognosis?

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Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful?

Cited by 117 publications

References 73 publications

Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

Prognostic Assessment of the Inflammatory Process Activity in Sarcoidosis of Respiratory Organs: Potential Use of C-reactive Protein and TNF-α

Destaques das diretrizes de doenças pulmonares intersticiais da Sociedade Brasileira de Pneumologia e Tisiologia

Recent advances in the pathogenesis and clinical evaluation of pulmonary fibrosis

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