Bronchoalveolar lavage in rheumatoid arthritis and secondary sjögren’s syndrome
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Bronchoalveolar lavage (BAL) was performed to investigate pulmonary involvement in 39 patients with rheumatoid arthritis (RA) and in 7 patients with RA and secondary Sjögren’s syndrome, and compared to 12 healthy controls. Lymphocytosis (more than 15%) was seen in 25, and more than 3% neutrophil granulocytes in 8 of 39 patients with RA. Lymphocytosis and/or neutrophil granulocytosis was seen in both seropositive and seronegative patients irrespective of clinical or radiologic findings. Patients with RA with or without secondary Sjögren’s syndrome had increased DR + lymphocytes in BAL compared with peripheral blood. In 7 patients with secondary Sjögren’s syndrome an increased helper/suppressor cell index (OKT4 + / OKT8+: 7.65 ± 2.10) and increased natural killer cells (OKNK +: 27.3 ± 5.5%) were found, as compared to 39 other patients with RA (OKT4+ / OKT8+: 2.16 ± 0.33, p<0.05; OKNK+: 14.5 ± 2.3%, p<0.05).
These BAL data are further evidence of frequent subclinical interstitial pulmonary involvement in RA with differences in the active autoimmune process from those in secondary Sjögren’s syndrome.
Key wordsBronchoalveolar lavage Rheumatoid arthritis Sjögren’s syndrome
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