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Semin Respir Crit Care Med 2007; 28(5): 504-513
DOI: 10.1055/s-2007-991523
© Thieme Medical Publishers

Bronchoalveolar Lavage in Occupational Lung Diseases

Carlos Robalo Cordeiro1 , Jessica Cemlyn Jones1 , Tiago Alfaro1 , António Jorge Ferreira2
  • 1Department of Pulmonology and Allergology, Coimbra University Hospital, Coimbra, Portugal
  • 2Institute of Hygiene and Social Medicine, Coimbra Medical School, Coimbra, Portugal
Further Information

Publication History

Publication Date:
02 November 2007 (online)

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ABSTRACT

Occupational lung diseases (OLDs) are related to the exposure and inhalation of organic, inorganic, and synthetic particles, fumes, gases, or infectious agents. From the long list of OLDs this article focuses the discussion on bronchoalveolar lavage (BAL) in parenchymal immunoinflammatory conditions, such as hypersensitivity pneumonitis (HP) and pneumoconiosis.

Several antigens may cause HP, including products of plant or animal origin, aerosolized microorganisms, and organic chemicals. BAL is used not only to assess the pathogenesis of these diseases but also to identify the typical pattern of intense lymphocytic alveolitis, usually with a CD4:CD8 ratio below normal and frequently with the presence of mast cells, plasma cells, and foamy macrophages.

Pneumoconioses are chronic interstitial lung diseases caused by the inhalation of mineral and metallic inorganic particles/dusts in an occupational setting, showing a decreasing prevalence in recent years.

BAL is a useful tool not only to express the complex pathogenic mechanisms of these entities but also in excluding other diagnoses and causes of alveolitis, and to document specific exposures, such as the identification of asbestos bodies (ABs) in asbestosis or the proliferative response of BAL lymphocytes to beryllium in chronic beryllium disease (CBD).

KEYWORDS

Bronchoalveolar lavage - occupational lung diseases - hypersensitivity pneumonitis - pneumoconiosis

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Carlos Robalo CordeiroM.D. Ph.D. 

Department of Pulmonology and Allergology, Coimbra University Hospital

Praceta Mota Pinto, 3000 Coimbra, Portugal

Email: crobalo@mail.telepac.pt