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FLOW SYTOMETRY FINDINGS AND SUBGROUP ANALYSES OF BAL FLUID IN INTERSTISIAL LUNG DISEASES. * HAKAN TANRIVERDİ *FİGEN ATALAY *MELTEM TOR *LEVENT KART *REMZİ ALTIN **İSHAK TEKİN * Zonguldak Karaelmas University Faculty of Medicine Chest Diseases **Immunology. Bronchoalveolar lavage (BAL).
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FLOW SYTOMETRY FINDINGS AND SUBGROUP ANALYSES OF BAL FLUID IN INTERSTISIAL LUNG DISEASES *HAKAN TANRIVERDİ *FİGEN ATALAY *MELTEM TOR *LEVENT KART *REMZİ ALTIN **İSHAK TEKİN *Zonguldak Karaelmas University Faculty of Medicine Chest Diseases **Immunology
Bronchoalveolar lavage (BAL) • Standard diagnostic procedure for the majority of patients with interstitial lung disease (ILD) • Helpful to understanding of ILD’s immunopathogenesis, differential diagnosis and monitoring therapy • Helpful to Sarcoidosis diagnosis and immunopathoenesis workup and determining the activity of sarcoidosis
AIM • We aimed to investigate flow cytometric findings of BAL fluid in patients with interstitial lung diseases and show that whether is there any differences for cell subgroups between patients groups
Material and method • Patients who underwent bronchoalveolar lavage for suspicion of interstitial lung diseases included the study • Patients' demographic data (age, gender, occupation, smoking habits) were recorded • Patients was categorized according to the final diagnosis • Subgroup analyses of BAL fluid was performed to assess differences between patients groups
Results • 84 patients • Mean age 52,24±14,14 (range 25-78) • 41 males (48,8%) • 43 females (51,2%)
İdiopathic İnterstitial Pneumoias (n=10 ) 8 IPF, 1 NSIP, 1 COP • Other ILDs n=8 2 Interstitial fibrosis 2 Clinical and radiological appropiate with ILD but no pathological comfirmations LAM, PAP, CEP, Vasculitis • Miscallenous n=5 2 Anthrocosis (female) 1 foreign body reaction 2 pneumonia
Results • İn sarcoidosis CD4/CD8, CD3, and lenfosytes were significantly higher CD3+1656 and CD1656 were significantly lower • BAL findings werenot significantly different between genders between smokers and nonsmokers among the subgroups of nonsarcoidosis patients
Conclusion • Our patients group was too heterogenous and small except sarcoidosis patients • BALf flow cytometry analyses can help us to distingush sarcoidosis from the other ILDs • But there is no difference among the ILDs
BALf in the diagnosis of IPF • 66 patients who had IPF clinic underwent BAL& open lung biopsy • No difference found for BALf cell populations • Lung biopsy 25 NSIP/ 41 UIP Veeraraghavan et al, 2002
Whereas the sensitivity of an elevated ratio higher than 3.5 or 4.0 is only 55% because of the high variability, the specificity is high at 95% • Thus sarcoidosis cannot be excluded if the CD4/CD8 ratio is normal or even decreased below Bronchoalveolar lavage in interstitial lung disease Ulrich et al.