ab1905

Subclinical pulmonary involvement assessed by broncho-alveolar lavage in patients with early undifferentiated connective tissue disease

G. Kumánovics, H. Zibotics¹, E. Juhász², A. Komócsi, L. Czirják

Nephrological Center and ²nd Department of Internal Medicine, University of Pécs, Medical Faculty; ¹Department of Lung Diseases, Baranya County Hospital;2Diagnostic Center, Pécs, Hungary.

ABSTRACT
Objective
To assess the presence of neutrophil and lymphocyte fibrosing alveolitis by bronchoalveolar lavage in patients with early undifferentiated connective tissue disease (EUCTD) and systemic sclerosis (SSc).

Method
Bronchoalveolar lavage (BAL) was performed in 13 patients with EUCTD who exhibited signs of lung involvement by non-invasive methods including lung function tests and high resolution computed tomography. The mean age of cases was 48.1 ± 6.6, and the mean disease duration was 1.8 ± 0.8 years.
Differential cell counts of BAL were evaluated. Eleven patients with systemic sclerosis and 5 healthy control subjects were also investigated.

Results
Eleven of the 13 EUCTD and 10 of the 11 SSc patients showed an elevated total cell number (above the median cell/ml of control + 2SD) in the BAL fluid. In patients with EUCTD, the lymphocyte count was elevated in 6, and the polymorphonuclear neutrophil count in 2 patients. One of the patients with EUCTD had simultaneously elevated lymphocyte and neutrophil granulocyte counts. In the SSc group, 6 patients had an elevated lymphocyte and 6 an increased neutrophil count. Three of these cases had both increased neutrophil and elevated lymphocyte counts, simultaneously.

Conclusion
Subclinical, predominantly lymphocyte alveolitis can be present in patients with EUCTD. Patients with SSc tend to exhibit neutrophil alveolitis.

Key words
Early undifferentiated connective tissue disease, systemic sclerosis, lung fibrosis, alveolitis, bronchoalveolar lavage.

This work was supported by the Hungarian Ministry of Health and Social Welfare, and by the National Foundation for Scientific Research (OTKA T026429, ETT 399/1996).
Please address correspondence to: László Czirják, MD, DSc, Head of the Clinical Immunology Unit, Nephrological Center and 2nd Department of Medicine, University of Pécs, Medical Faculty, Pacsirta u. 1., H-7624 Pécs, Hungary
E-mail: laszlo.czirjak@aok.pte.hu