Title:Bronchoalveolar Lavage in Systemic Sclerosis Patients: A Systematic Review
Volume: 17
Issue: 2
Author(s): Sérgio Oliveira da Silva, Adriane Souza da Paz, Isla Miranda Vidal Cavalcante Farias, Damille Sandes Moreira, Marianna Alegro Fontes Ribeiro, Tatiana Senna Galvão Nonato Alves, Antônio Carlos Moreira Lemos and Mittermayer Barreto Santiago*
Affiliation:
- Complexo Hospitalar Universitário Professor Edgard Santos, Rua Doutor Augusto Viana, s/n, Canela, CEP 40110-060, Salvador, Bahia,Brazil
Keywords:
Systemic sclerosis, scleroderma, interstitial lung disease, Bronchoalveolar lavage, alveolitis, pulmonary disease.
Abstract: Introduction: We performed a systematic review of the literature to determine the value
of bronchoalveolar lavage (BAL) in evaluating the pulmonary involvement of systemic sclerosis
(SSc).
Methods: Articles published between 1980 and 2019 were retrieved from the databases: PubMed
and Scielo. The search was restricted to clinical trials published in English, utilizing the keywords
“scleroderma, systemic sclerosis, interstitial lung disease, and bronchoalveolar lavage”.
Results: Twenty-two papers were analyzed. A positive correlation was observed between increased
BAL cellularity (alveolitis) and worsening clinical symptoms, pulmonary function, and radiological
pattern in 2, 11, and 15 studies, respectively. The majority of BAL studies that evaluated interleukin
levels, including TNF-α, IL-6, IL-7, and IL-8, observed higher levels in patients with impaired
pulmonary function and increased lung involvement.
Conclusions: Alveolitis and the increase of some cytokines/chemokines in BAL were related to
more severe pulmonary disease in SSc in the majority of the studies and seemed to be markers of
worse prognosis, but it is unknown whether BAL adds clinical value to the use of the other non-invasive
diagnostic procedures.
