Correlation of lower respiratory tract inflammation with changes in lung function and chest roentgenograms in patients with untreated tropical pulmonary eosinophilia.

Vijayan, V.K.; Sankaran, K.; Venkatesan, P.; Kuppu Rao, K.V.

Singapore Medical Journal; 1991; 32; 122-125.

Forty-one patients with untreated tropical pulmonary eosinophilia (TPE) were studied to determine whether was any relationship between lower respiratory tract inflammation and either changes in lung function or abnormalities in chest roentgenograms. Total number of inflammatory cells in bronchoalveolar lavage (BAL) fluid, consisting of alveolar macrophages, lymphocytes, eosinophils and neutrophils had significant negative correlations with transfer factor (TLCO) (r = -0.519, p < 0.001), transfer coefficient (KCO) (r = -0.312, p <0.05) and total lung capacity (TLC) (r = -0.352, p < 0.05). The absolute count of eosinophils in BAL fluid had a significant negative correlation with TLCO (r = -0.430, p < 0.01) and KCO (r = -0.300, p = 0.05), but not with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV t ) or TLC. However, the absolute count of alveolar macrophages had a significant negative correlation with FVC (r = -0.343, p < 0.05), FEV t (r = -0.341, p < 0.05) and TLC (r = -0.305, p < 0.05), but not with TLCO or KCO. The total number of lymphocytes had a negative correlation with TLC (r = -0.315, p<0.05). There was no correlation between the types of cells recovered in BAL fluid and changes in chest radiographs as assessed by the ILO classification for occupational lung diseases. These data suggest that there may be a disassociation of pulmonary pathophysiological changes produced by different inflammatory cells in the lower respiratory tract. Macrophages and lymphocytes may produce more harm to the lung, as evidenced by significant negative correlations of these cells with lung volumes.


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