title: Bronchoalveolar lavage impact in sarcoidosis: study of 40 cases.
abstract: BACKGROUND
  Studies on bronchoalveolar lavage (BAL) fluid samples profile characteristics in sarcoidosis patients hitherto reported in literature give rise to conflicting data. The typical finding is lymphocytic alveolitis with a high CD4/CD8 ratio, although a broad range of values has been found. THE AIM of the study was to evaluate different parameters of BAL fluid in patients with sarcoidosis before and after corticosteroid treatment and to determine the reliability of BAL in evaluating prognosis of sarcoidosis.
  
  
  METHODS
  The study involved 40 patients with clinical and histological evidence of sarcoidosis.
  
  
  RESULTS
  Before treatment, BAL fluid showed an increase in total cell count and a T lymphocytosis with an increase in the CD4/CD8 ratio. After treatment, we have noted a significantly increase in macrophage proportion, a significantly decrease in lymphocyte proportion and in CD4/CD8 ratio. A significant higher CD4/CD8 ratio was noted in patients with multiple extrathoracic lesions compared with patients with only intrathoracic involvement and in patients with unfavourable evolution compared with patients with improved evolution.
  
  
  CONCLUSIONS
  When typical clinical and radiological findings definitely suggest sarcoidosis, BAL results may add a biological support. Our data suggests that a high CD4/CD8 ratio seems to be predictive of poor prognosis with a multiple extrathoracic organ involvement and an unfavourable outcome.
authors.affiliation: Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Dhouha
authors.initials: D
authors.lastname: Bacha
authors.forename: Aïda
authors.initials: A
authors.lastname: Ayadi-Kaddour
authors.forename: Olfa
authors.initials: O
authors.lastname: Ismail
authors.forename: Faouzi
authors.initials: F
authors.lastname: El Mezni
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D016516:CD4-CD8 Ratio; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000473:pathology*