The Value of Bronchoalveolar Lavage in the Diagnosis and Management of Specific Ild Idiopathic Pulmonary Fibrosis

Abstract

Diffuse parenchymal lung diseases (DPLD) encompasses a hetero-geneous group of disorders, characterized by a spectrum of inflammatory and fibrotic changes affecting alveolar walls and air spaces. The onset, rate of progression and duration of symptoms are extremely variable, and presentations range from asymptomatic with long standing radiological changes to an acute onset of breathlessness. MATERIALS AND METHODS: Prospective study conducted on 30 patients admitted in Government general and chest hospital Hyderabad, All patients with clinical features and HRCT diagnostic of Idiopathic pulmonary fibrosis are included in the study. Study was done between February 2013 to December 2014. BAL was done based on ATS guidelines. RESULTS: Out of 30 patients, 19 were females and 11 were males. Out of 30 patients, 21 patients were having neutrophils as predominant cell type in BAL fluid, 6 patients were having lymphocytes as predominant cell type and 2 were having eosinophils and 1 patient was having macrophages as predominant cell type in BAL fluid. In patients with neutrophil predominant BAL fluid, 8 patients found to be having exclusively neutrophils and other cells were within normal limits and 5 were having raised lymphocytes, 5 were having raised eosinophils along with neutrophils and 3 patients were having both lymphocytes and eosinophils along with neutrophils. In patients with lymphocyte predominant BAL fluid, 1 patient is having exclusively raised lymphocytes and 5 patients were having raised neutrophils along with lymphocytes in BAL fluid. 2 patients were having exclusively raised eosinophils in BAL fluid.