Bronchoalveolar lavage during inhalation provocation test in a case of farmer's lung disease

Bronchoalveolar lavage (BAL) was performed in order to reveal inflammatory immune processes during inhalation provocation test in a patient with farmer's lung disease. Three hours after inhalation challenge the patient showed dyspnea and an increase in body temperature to 38.9 degrees C, restrictive and obstructive impairment, and a decrease in peripheral lymphocytes from, 2.8 x 10(3)/mm3 to 1.8 x 10(3)/mm3, although peripheral granulocytes increased from 4.4 x 10(3)/mm3 to 10.3 x 10(3)/mm. BAL fluid at that time showed increases in lymphocytes, granulocytes and macrophage, as well as proteins and complements, compared with that before the inhalation test. These findings indicate that with inhalation challenge in a patient with farmer's lung disease, inflammation increases vascular permeability while protein loss is followed by an increase in lymphocytes, granulocytes and macrophage; the lymphocytes migrate to the lung from peripheral blood.