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- W2170706007 abstract "To assess the usefulness of bronchoalveolar lavage (BAL) collagenase measurement in gauging disease severity and outcome in sarcoidosis, we analyzed BAL fluids from 84 patients with sarcoidosls for collagenase and monitored disease progress in these patients for a minimum of 12 months. Twenty patients (24%) were found to have BAL collagenase activity on initial evaluation (collagenase-positive group). Compared with patients without BAL collagenase (collagenase-negative group), the collagenase-positive group had (1) a higher proportion of BAL suppressor T cells (p < 0.03); (2) a lower helper-suppressor T-cell ratio (p < 0.002); (3) lower mean percent predicted FEV1, FVC, and DlCO levels (p < 0.05); and (4) a higher proportion of patients with advanced (Stage 4) disease on chest roentgenogram (p < 0.001). Significant differences were also observed between the collagenase-positive and collagenase-negative groups during follow-up. A higher proportion (55%, n = 11) of collagenase-positive patients required corticosteroid therapy than did collagenase-negative patients (26%; n = 17; p < 0.025). Of those who remained untreated, pulmonary function tended to decrease in the collagenase-positive group, whereas mean pulmonary function levels actually improved in the collagenase negative group (p < 0.05). Of those who required therapy, mean percent predicted FVC and DlCO levels improved significantly after treatment in the collagenase-negative group (p < 0.01 and p < 0.05, respectively), whereas an improvement in percent predicted FVC levels only (p < 0.01) was observed in the collagenase-positive group. In the 11 steroid-treated collagenase-positive patients, repeat BAL collagenase measurements taken while they received therapy showed a significant decrease from pretreatment levels (p < 0.001), with levels returning to normal (i.e., undetectable) in six patients.This study indicates that as a group, sarcoid patients with BAL collagenase have more severe physiologic and radiologic impairment and a greater need for steroid intervention than do patients without BAL collagenase. Finally, steroid therapy results in a significant reduction in BAL collagenase activity. These results suggest that the presence of collagenase in BAL fluids from patients with sarcoidosls may reflect severity of disease and an increased likelihood of an adverse disease outcome." @default.
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- W2170706007 date "1990-09-01" @default.
- W2170706007 modified "2023-09-27" @default.
- W2170706007 title "Pulmonary Disease Progress in Sarcoid Patients with and without Bronchoalveolar Lavage Collagenase" @default.
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- W2170706007 doi "https://doi.org/10.1164/ajrccm/142.3.636" @default.
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