Diagnostic value of bronchoalveolar lavage in interstitial lung diseases

Bronchoalveolar lavage (BAL) is currently widely applied to sample cells and proteins present in the bronchoalveolar space for subsequent studies. Moreover, this limited invasive technique is a sensitive indicator of infectious and non-infectious inflammatory disorders, such as interstitial lung diseases. The aim of this study was to investigate the clinical applications of BAL, in particular the diagnostic value of this method with a view to preventing more invasive procedures. The studies presented in this thesis are based on BAL fluid data obtained from patients during a ten-year period between 1980 and 1990. Cells and proteins, ie, albumin and immunoglobulins, determined in those BAL fluid samples, have been analyzed. Retrospectively, we searched for specific features in the data from the BAL fluid analyses, which distinguish between various interstitial lung diseases. This thesis describes the diagnostic value of BAL fluid sample analyses in patients suffering from various interstitial lung diseases. Emphasis is put on patients with sarcoidosis, extrinsic allergic alveolitis (EAA), or idiopathic pulmonary fibrosis.