Diagnostic Value of Increased Bronchoalveolar Lavage Fluid Eosinophile and Lymphocyte in Patients with Acute Respiratory Failure Accompanied by Diffuse Pulmonary Infiltrates

摘要

From 1983 to 1997, we examined the usefulness of bronchoalveolar lavage (BAL) cell differential counts, with special reference to increased levels of eosinophils and lymphocytes, in patients with acute respiratory failure accompanied by diffuse shadow in chest radiographs. This study covers 118 patients with acute respiratory failure who had a Pao_2 of less than 60 mmHg on room air or an oxygenation index (Pao_2/ FIo_2) of less than 250 mmHg and diffuse shadows in chest radiographs. Pulmonary disease was evaluated on the basis of clinical findings, results from studies of specimens from bron-choscopy, transbronchial and/or open lung biopsy specimens, and other relevant examinations. Increases in the eosinophil percentage in BAL are found in several specific pulmonary diseases, especially in acute eosinophilic pneumonia and bronchitis obliterans with organized pneumonia. In addition, other specific diseases, such as miliary tuberculosis, hypersensitivity pneumonia, IIP and Pneumocystis carinii pneumonia show elevated levels of increased lymphocytes in the BAL.