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Diagnostic Values Of Neopterin In Serum And Bronchoalveolar Lavage Samples In Pulmonary Sarcoidosis

Volume 2 - Issue 11, November 2018 Edition
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Author(s)
Deniz Dogan, Canturk Tascı, Seyfettin Gumus, Ergun Ucar, Arzu Balkan, Omer Deniz, Ergun Tozkoparan, Metin Ozkan, Halil Yaman, Hayati Bilgic
Keywords
bronchoalveolar lavage, neopterin, sarcoidosis, tuberculosis.
Abstract
Neopterin (NP), an marker of cellular immunity, is emitted from monocyte and macrophages through interferon-γ stimulation. Sarcoidosis is a systemic granulomatous disease and mainly involves lungs and lymphoid tissue. In this study we aimed to evaluate the diagnostic value of serum and Bronchoalveolar lavage (BAL) NP levels in lung sarcoidosis and its correlation through clinical parameters. Serum measurements were performed in 26 patients with sarcoidosis and 16 healty patients. Serum and BAL NP levels were significantly higher in the group with sarcoidosis (17.42±6.91 nmol/L and 1.50±1.46 mcmol/g-prt) than the group with non-sarcoidosis lung disease (12.38±7.46 nmol/L and 0.62±0.75 mcmol/g-prt) and the healthy group (8.12±4.20 nmol/L 0.42±0.22 mcmol/g-prt). In sarcoidosis BAL NP measurement was determined as 92%, 35%, 75% and 68% in means of specifity, sensitivity, PPD and NPD, respectively. In assessing sarcoidosis and tuberculosis differential diagnosis, BAL NP measurements were detected as 89%, 53%, 90% and 50% in means of specifity, sensitivity, PPD and NPD, respectively. BAL NP levels expressively proved correlation with radiological stage (r=0.879), FVC (r=-0.645), DLCO (r=-0.611) and DLCO/VA (r=-0.615). Serum NP levels just expressively showed correlation with FVC (r=-0.481) and FEV1 (r=0.507) values. It has been concluded that serum and BAL NP levels increased in sarcoidosis cases compared to healthy individuals and the other disease cases and these parameters are correlated with radiological stage, FVC and DLCO parameters, which are fundamental determinants in pulmonary sarcoidosis prognosis and treatment decision. We consider high BAL and serum NP levels may support sarcoidosis diagnosis in case invasive diagnostic applications cannot be made.
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