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2007, Number 3

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Rev Inst Nal Enf Resp Mex 2007; 20 (3)

Lymphocytosis in bronchoalveolar lavage can predict the response to treatment in hypersensitivity pneumonitis

Mejía ÁME, Estrada GA, Suárez LT, Alonso MD, Navarro MC, Gaxiola GM, Barrientos E, Rojas-Serrano J, Carrillo-Rodríguez JG

Language: Spanish
References: 15
Page: 183-188
PDF size: 83.41 Kb.


ABSTRACT

Lymphocytosis in bronchoalveolar lavage is a good diagnostic indicator and treatment response predictor in patients with hypersensitivity pneumonitis (HN).
Objective: To determine if there is a percentage in the lymphocytosis of bronchoalveolar lavage (BAL) in patients with HN, that is associated with a favorable response to treatment.
Method: Thirteen HP patients with improvement defined as an increase › 10% of the basal FVC and an increase › 4% in oxygen saturation or arterial oxygen pressure after two years of treatment were compared with 13 patients with progression of the disease (decrease of ≥ 10% of the basal FVC and a decrease of › 4% of the oxygen saturation or arterial oxygen pressure). All patients had a cellular count in BAL at the first visit as a part of their study protocol.
Results: The improved group showed a higher percentage of BAL lymphocytosis compared with the nonimproved group (79±16 vs. 53±15%, p ‹ 0.001). When the cut-off point was fixed at a limit of 68% lymphocytes, 11/13 of the improved patients were over this limit; in contrast, only 3/13 in the nonimproved group were over this limit (RR of 0.204 and 95% CI of 0.05-0.72), sensitivity of 84%, specificity of 77% (positive predictive value of 78%).
Conclusions: Lymphocytosis of 68% or more in BAL of patients with HN could predict a good response to treatment.


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