Introduction: We performed a systematic review of the literature to determine the value
of bronchoalveolar lavage (BAL) in evaluating the pulmonary involvement of systemic sclerosis
Methods: Articles published between 1980 and 2019 were retrieved from the databases: PubMed
and Scielo. The search was restricted to clinical trials published in English, utilizing the keywords
“scleroderma, systemic sclerosis, interstitial lung disease, and bronchoalveolar lavage”.
Results: Twenty-two papers were analyzed. A positive correlation was observed between increased
BAL cellularity (alveolitis) and worsening clinical symptoms, pulmonary function, and radiological
pattern in 2, 11, and 15 studies, respectively. The majority of BAL studies that evaluated interleukin
levels, including TNF-α, IL-6, IL-7, and IL-8, observed higher levels in patients with impaired
pulmonary function and increased lung involvement.
Conclusions: Alveolitis and the increase of some cytokines/chemokines in BAL were related to
more severe pulmonary disease in SSc in the majority of the studies and seemed to be markers of
worse prognosis, but it is unknown whether BAL adds clinical value to the use of the other non-invasive