IMMUNOLOGICAL AND PULMONARY-FUNCTION ABNORMALITIES IN TROPICAL PULMONARY EOSINOPHILIA

Twenty six patients (24 males and 2 females) with tropical pulmonary e osinophilia (TPE) were studied. Arterial blood gas analysis, pulmonary functions, peripheral blood examination and bronchoalveolar lavage (B AL) were performed. Peripheral blood and BAL fluid analyses were perfo rmed in healthy volunteers. Pulmonary functions revealed a mild restri ctive ventilatory defect with airways obstruction. Mild hypoxaemia was observed on arterial blood gas analysis. Serum immunoglobulins Ige (P < 0.01), IgA (P < 0.001) and IgM (P < 0.001) were significantly raise d as compared to normal controls. Serum complement (C3) level was high er, however, it was not significantly different as compared to normal controls. Serum haemolytic component of the complement (CH50) was sign ificantly higher (P < 0.001) in patients with TPE compared to normal c ontrol subjects. The immunoglobulins Igc, IgA and IgM in the BAL fluid were significantly (P < 0.001) increased as compared to normal contro ls. The fibronectin (FN) level was also significantly increased (P < 0 .001) in the BAL fluid. It is concluded that patients with TPE have mi ld restrictive ventilatory defect with airways obstruction and mild hy poxaemia. They have eosinophilic alveolitis with increased levels of i mmunoglobulins in the peripheral blood and BAL fluid. The significance of elevated FN in the BAL fluid is not clear and serial estimations m ay have to be done in order to clarify its role in the pathogenesis of fibrosis in chronic TPE.