A computer program using BALF-analysis results as a diagnostic tool in interstitial lung diseases.

Abstract

Recently, we showed that it is possible to distinguish between three common interstitial lung diseases (ILD) with similarities in clinical presentation by using a number of selected variables derived from bronchoalveolar lavage fluid (BALF) analysis. The aim of this study was to develop a more general discriminant model, based on polychotomous logistic regression analysis. The 277 patients involved in the study belonged to diagnostic groups with sarcoidosis (n = 193), extrinsic allergic alveolitis (EAA; n = 39), and idiopathic pulmonary fibrosis (IPF; n = 45). The diagnosis had been established independently of the BALF-analysis results. The variables used to discriminate among these patient groups were the yield of recovered BALF, total cell count, and percentages of alveolar macrophages, lymphocytes, neutrophils, and eosinophils. In order to test the predictive power of the logistic model, we used 128 patients having sarcoidosis (n = 91), EAA (n = 5), or IPF (n = 32) from another hospital. In this test set the agreement of predicted with actual diagnostic-group membership was the same as in the learning set in which the logistic model was fitted: 94.5% of the cases were correctly classified. A validated computer program based on the polychotomous logistic regression model can be used to predict the diagnosis for an arbitrary patient with information provided by BALF analysis, and is thought to be of diagnostic value in patients suspected of having ILD.

Sarcoidosis- A Clinicoradiological Profile of 30 Patients

“…They also highlighted that in sarcoidosis the majority of cases have an increased number of lymphocytes and a normal number of eosinophils/neutrophils and in severe cases the number of neutrophils can be increased as well. 62 The cell discrimination findings of BALF in the present study were revealed the predominance of lymphocytic plus neutrophilic and lone lymphocytic alveolitis.…”

The CD4/CD8 ratio in BAL fluid is highly variable in sarcoidosis

“…They found a positive predictive value of 92.2% and negative predictive value of 97.1% for BAL cell differential in diagnosing sarcoidosis, and then applied computerassisted analysis of BAL findings (excluding lymphocyte subset analysis) to a similar patient population with a high degree of accuracy [41]. CHECK et al [26] generated likelihood ratios based upon relative percentage of lymphocytes in BAL from a database of 208 patients with BAL cellular differential analyses, and provided this information to clinicians evaluating patients for sarcoidosis.…”

Recurrent respiratory distress associated with carbamazepine overdose

“…Again, haemodialysis was required. BALF analysis revealed a total cell amount of 35.3×10 4 cells·mL -1 ; (reference value for smokers 29.2± 3.3×10 4 cells·mL -1 ), with a predominance of neutrophils (89.4%; reference value for smokers 1.2±1.6%) [10]. Again, serum LDH was increased (2160 U·L -1 ; fig.…”