What is the role of induced sputum analysis in the workup of sarcoidosis?

Updated: Sep 15, 2020
  • Author: Nader Kamangar, MD, FACP, FCCP, FCCM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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In at least one study, the CD4/CD8 ratio and tumor necrosis factor (TNF)–α levels in induced sputum correlated with those in bronchoalveolar lavage fluid (BALF) and paralleled changes with treatment. Induced sputum may therefore be a surrogate for BALF for certain markers in patients with sarcoidosis. [56] In another study, the differential cell count in BALF demonstrated a significantly lower percentage of neutrophils and a significantly higher percentage of macrophages than in induced sputum. The profiles of T-cell subsets, however, showed the same pattern in both groups. A CD4/CD8 ratio of 2.5 or greater had a sensitivity of 100% and a specificity of 81.2%, with a positive predictive value of 81.2%, to distinguish sarcoidosis from nongranulomatous interstitial lung diseases.

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