Subclinical pulmonary involvement assessed by bronchoalveolar lavage in patients with early undifferentiated connective tissue disease

Clin Exp Rheumatol. 2001 Sep-Oct;19(5):551-9.


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 + 2 SD) 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bronchoalveolar Lavage Fluid / cytology*
  • Female
  • Flow Cytometry
  • Humans
  • Lymphocyte Count
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Mixed Connective Tissue Disease / complications
  • Mixed Connective Tissue Disease / pathology*
  • Neutrophils / pathology
  • Pulmonary Fibrosis / diagnostic imaging
  • Pulmonary Fibrosis / etiology
  • Pulmonary Fibrosis / pathology*
  • Pulmonary Fibrosis / physiopathology
  • Radiography, Thoracic
  • Respiratory Function Tests
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / pathology
  • T-Lymphocyte Subsets / cytology