The characteristics of bronchoalveolar lavage from a patient with antiphospholipid syndrome who developed acute respiratory distress syndrome

The purpose of this study was to investigate the biochemical characteristic s as well as the occurrence and specificity of antiphospholipid antibodies in the bronchoalveolar lavage (BAL) fluid from a patient with both antiphos pholipid antibodies syndrome (APS) and acute respiratory distress syndrome (ARDS). Proteins, lipids, cells and autoantibodies were determined. Immunog lobulins were purified with affinity chromatography. Autoantibody identific ation was assessed with enzyme-linked immunosorbent assay (ELISA) and with electrophoresis, followed by immunoblotting and revelation with antihuman I gG-peroxidase conjugate. Antiphospholipid antibodies were found to be prese nt in the BAL fluid as well as in the serum from a patient with APS. Specif ically, antiphosphatidylserine and antiphosphatidic acid IgG antibodies in the BAL fluid and antiphosphatidylcholine and anticardiolipin IgG antibodie s in the serum were detected at high levels. BAL fluid protein and the perc entage of neutrophils were found to be increased. R quantitative as well as qualitative deficiency of surfactant phospholipids was also observed. Anti bodies directed against surfactant phospholipids could cause surfactant abn ormalities and an inflammatory reaction. These disorders may be one of the causes of the ARDS or a factor in the perpetuation of the inflammation.