Broncho-alveolar Lavage (BAL) for the Diagnosis of Sarcoidosic Uveitis

Abstract

Purpose: To evaluate the use of BAL for the diagnosis of sarcoidosic uveitis.

Methods: Retrospective study of 109 consecutive patients with uveitis and minimum 2 signs of ocular sarcoidosis who had a BAL and chest imaging. BAL⁺ was defined as an alveolar (a) lymphocytosis (L) aL > 15% with aCD4/CD8 > 3.5. Serum angiotensin converting enzyme (sACE), tuberculin skin test and gallium scan were tested in 83, 95 and 24 patients.

Results: BAL was + in 26.6% of patients (86.2% females, mean age 50.8y) with mean aL = 46.8% and mean aCD4/CD8 = 8.5 which significantly differed form BAL⁻ patients: 62.5% females, p < 0.02, mean age 43.6y, p < 0.05, mean aL = 17.2%, p < 0.001 and mean aCD4/CD8 = 1.8, p < 0.001. BAL⁺ patients had 31% of bilateral hilar adenopathy (BHL⁺), and 59.1% of elevated sACE which significantly differed form BAL⁻ patients: 8.8%, p = < 0.01 and 14.8% p < 0.001.

Conclusion: Our findings suggest that BAL have a high diagnostic value and might be a useful additional test for the diagnosis of sarcoidosic uveitis, even with normal chest imaging.

• aCD4/CD8
• alveolar lymphocytosis
• BAL
• BHL
• bronchoalveolar lavage
• chest imaging
• chest x-ray
• HRCT
• ocular sarcoidosis
• uveitis