Document resource
Introduction Bronchoalveolar lavage (BAL) is increasingly utilised in the diagnostic workup of interstitial lung disease (ILD) patients, often reducing the need for more invasive procedures like surgical biopsy. However, definitive data on how BAL results should consistently guide diagnostic and therapeutic decision-making in ILD management remain limited.Objective To evaluate the utility of BAL cellularity, alongside other clinical and investigative findings, in the diagnosis and management of ILD patients within our hospital, and to assess its correlation with the overall disease course.Method We conducted a retrospective review of patients who underwent BAL for ILD at Hull University Teaching Hospital from October 2021 to January 2024. Baseline demographics, pulmonary function tests (PFTs), high-resolution computed tomography (HRCT) findings, preliminary diagnoses, predominant BAL cellularity, administered treatments, and overall patient outcomes were analysed.Results A total of 19 patients with non-idiopathic pulmonary fibrosis (IPF) ILD underwent BAL. The key findings are summarized in table 1.Abstract P101 Table 1Demographic, clinical, radiological, BAL, and outcome data for ILD patients who underwent BAL. Continuous data are presented as mena (range)Conclusion In this case series of 19 patients with non-IPF ILD who underwent BAL, cellular analysis contributed to the confirmation or exclusion of diagnoses amenable to steroid-responsive treatment. Although BAL cellularity aided early decision making regarding antifibrotic versus immunosuppressive therapy, the rate of FVC decline and mortality remains comparable to Idiopathic pulmonary fibrosis. This highlights the complex nature of non-IPF ILDs. A prospective, multi-centre study with extended follow-up is warranted to definitively establish the comprehensive role of BAL in the long-term management and prognostic assessment of ILD.