Bronchoalveolar lavage cellular patterns in monoclonal antibody-induced lung disease

Shikha Gupta, Patricia Smith, Homer Twigg, Chadi Hage

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The increase in the use of monoclonal antibodies (mAB) as a targeted therapy for a variety of diseases has been accompanied by an increase in reports of interstitial lung abnormalities in treated patients. Objective: Bronchoalveolar lavage (BAL) is routinely performed in these patients to rule out infection, so we sought to determine the BAL cellular pattern in individuals with mAB-induced lung disease (mAB-ILD). Methods: We utilized a case-control study design. Among patients treated with mAB, cases were defined as those with otherwise-unexplained interstitial lung abnormalities, which resolved after cessation of treatment, while controls were defined as those with interstitial abnormalities clearly explained by other etiologies. Results: From 2000 to 2012, we identified 9 cases and 7 controls. The mean age of the cases was 62.6 ± 26 years and 6 were female. The most common radiographic finding was diffuse ground-glass opacities. The most common BAL cellular pattern was mixed inflammation with moderate lymphocytic and mild neutrophilic alveolitis. The cases had a higher mean lymphocyte count than the controls (40.1 ± 32.6 vs. 13.1 ± 25.5, p = 0.008). The rest of the BAL cellular analyses were similar between the 2 groups. The median CD4:CD8 ratio in 7 patients with >15% lymphocytes was 0.9 (0.6-3). There was no significant difference in the CD4:CD8 ratio between the 2 groups. Conclusions: Mixed inflammation with moderate lymphocytic and mild neutrophilic alveolitis is the most common BAL cellular pattern in patients with mAB-ILD. Such findings may be useful for the early identification of mAB-ILD.

Original languageEnglish (US)
Pages (from-to)185-189
Number of pages5
JournalRespiration
Volume88
Issue number3
DOIs
StatePublished - Apr 18 2014

Fingerprint

Bronchoalveolar Lavage
Lung Diseases
Monoclonal Antibodies
CD4-CD8 Ratio
Inflammation
Lung
Withholding Treatment
Lymphocyte Count
Glass
Case-Control Studies
Lymphocytes
Infection

Keywords

  • Bronchoalveolar lavage
  • Interstitial lung disease
  • Monoclonal antibody

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Bronchoalveolar lavage cellular patterns in monoclonal antibody-induced lung disease. / Gupta, Shikha; Smith, Patricia; Twigg, Homer; Hage, Chadi.

In: Respiration, Vol. 88, No. 3, 18.04.2014, p. 185-189.

Research output: Contribution to journalArticle

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