Bronchoalveolar lavage and silicosis pathogenesis.
Teles de Araujo A; Mendes AC; Monteiro J; Duarte G; Costa MF
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 90-108, 1990 Sep; (Part I):436-442
An evaluation was conducted of a group of 34 long term silica (14808607) exposed workers with a broad spectrum of disease manifestations through clinical chest X-ray, functional and bronchoalveolar lavage (BAL) fluid investigations. The evaluation was performed to achieve a better comprehension of the disease pathogenesis and evaluate the eventual correlation between the BAL data and clinical manifestations. The patients ranged in age from 31 to 78 years. Fifteen were smokers. The patients were divided into two groups. Group-I contained 22 patients without or only with bronchial complaints, radiograph of the category-1 and normal functional tests or with a mild obstructive syndrome. Group-II contained 12 patients with complaints suggestive of interstitial involvement, chest X-ray above category-2 and frequency with coalescence of lesions and functionally with volumetric restriction. The composition of lower respiratory tract fluid clearly reflected the clinical spectrum of the respiratory disease caused by chronic inhalation of silica containing dust. In BAL effluents of category- II patients, the most impressive increases of immunological and inflammatory effector cells were noted. In the patients with alveolitis, the ventilatory impairment was more frequent and important. There was also evidence of local cellular and humoral immune abnormalities in silicotic patients.
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