EFFECT OF CORTICOSTEROID TREATMENT ON VARIOUS SEROLOGICAL AND BRONCHOALVEOLAR LAVAGE ABNORMALITIES IN PATIENTS WITH SARCOIDOSIS

Effect of daily oral prednisolone treatment was studied in 29 patients with pulmonary sarcoidosis. Twenty normal control subjects were also studied, Pretreatment absolute lymphocyte counts and proportion of lym phocytes in peripheral blood were significantly lower in patients with sarcoidosis as compared to normal controls, Total cell count and the proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid were s ignificantly higher in sarcoidosis. The proportion of CD3+ and CD4+ wa s significantly lower in peripheral blood and higher in BAL fluid in p atients with sarcoidosis, Immunoglobulins (IgG, A and M) and complemen ts (C3, C4 and CH50) were significantly higher both in peripheral bloo d and BAL fluid, Patients with sarcoidosis were treated with daily ora l prednisolone (30 mg/day), Repeat studies were performed after an int erval of 4-6 months in 20 patients with sarcoidosis. A significant inc rease in absolute lymphocyte counts in peripheral blood and decrease i n the proportion of lymphocytes in BAL fluid occurred with prednisolon e treatment, Proportion of CD3+, CD4+ and B cells increased in periphe ral blood and decreased in BAL fluid. Complement and immunoglobulin le vels revealed a significant reduction in peripheral blood and BAL flui d, It is concluded that patients with sarcoidosis have peripheral bloo d lymphopaenia and lymphocytic alveolitis. They have increased levels of complement and immunoglobulins both in the peripheral blood and BAL fluid. All these abnormalities show significant improvement with pred nisolone treatment.