A woman is admitted with complains of low-grade fever of 6 weeks duration. Chest radiograph reveals bihilar adenopathy with clear lung fields. All of the following investigations will be useful in differential diagnosis except: (AIIMS Nov 2009)
|A||CD4/CD8 counts in the blood|
|B||Serum ACE levels|
|C||CECT of chest|
CD4/CD8 counts in the blood
1). Bronchoalveolar lavage (BAL) shows increase lymphocytes in active disease, neutrophil with pulmonary fibrosis. A ratio of CD 4 to CD8 (CD4 / CD8) > 3.5 in BAL (But not in blood) is highly suggested of sarcoidoses.
2). While there is marked enhancement of number of TH cells at the sites of disease, the number of TH cells in the blood are normal.
Extra Edge: In sarcoidosis
1). Tuberculin skin test is negative
2). CXR is abnormal in 90%:
Stage 0: normal.
Stage 1: B/L hilar lymph adrenopathy
Stage 2: BHL + peripheral pulmonary infiltrate
Stage 3: peripheral pulmonary infiltrates alone.
Stage 4: progressive pulmonary fibrosis; bulla formation (honeycombing);