الفهرس 
Factors affecting bronchoalveolar lavage cellularity in patients with hypersensitivity pneumonitis
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Abstract
Background: Hypersensitivity pneumonitis (HP) refers to the inflammatory lung condition that arises from inhalational exposure to various (mostly organic) antigens with the development of lymphocytic alveolitis and granulomatous pneumonitis. Disease pathogenesis is not fully understood and identification and removal of the offending agents remains the cornerstone of treatment and a major determinant of prognosis. Bronchoscopy and BAL can be used to characterize alveolitis and inflammatory cells infiltrate which is assumed to have a main role in the pathogenesis of the disease process. Subjects and methods: 88 HP cases diagnosed by thorough history, clinical examination, HRCT (with scoring system for each radiological pattern), spirometry, and FOB with BAL for cellularity and flowcytometry (FCM) to determine CD4/CD8 ratio. Results: The mean total cell count (TCC)/cmm was (397±241) in subacute cases and (247±291) in chronic cases with statistically significant difference P-value 0.002. Mean lymphocytes percent was (45±19%) in subacute cases and 39±20% in chronic cases with no statistically significant value. There was no difference between subacute and chronic cases regarding CD4/CD8 ratio but there was a positive correlation between time elapsed since last exposure and CD4/CD8 ratio with P-value 0.006 and r = 0.505. Conclusion: BAL can aid in the diagnosis of HP if done with experienced technique. Greater than 40% BAL lymphocytosis supports HP diagnosis while less than 20% suggests another diagnosis