RELATIONSHIP BETWEEN PRESENTATION OF SARCOIDOSIS AND T-LYMPHOCYTE PROFILE - A STUDY IN BRONCHOALVEOLAR LAVAGE FLUID

One hundred patients with histologically verified sarcoidosis were stu died. They were divided into three groups, based on their clinical pre sentation and smoking status. Group A consisted of patients whose dise ase was detected by routine chest x-ray film, without symptoms; group B included those with respiratory and general constitutional symptoms; and group C included patients with erythema nodosum and/or arthralgia and hilar lymphadenopathy. Group A showed an increased CD4/CD8 ratio of 4.7 +/- 1.1; group B, 8.0 +/- 1.2; and group C counted for the high est ratio of 10.7 +/- 1.5. Cigarette smoking modifies the immunologic bronchoalveolar lavage (BAL) fluid sample profile, since alveolitis wa s less pronounced in smokers. In addition, BAL fluid samples obtained from sarcoidosis patients with hilar lymphadenopathy showed the most c haracteristic features of alveolitis, suggesting a disseminated instea d of a local immune response. Therefore, the clinical presentation of sarcoidosis and the smoking status of a sarcoidosis patient are crucia l for interpreting individual lavage analysis results.