Experience With Flexible Fiberoptic Bronchoscopy With Bronchoalveolar Lavage as a Diagnostic Tool in Children With AIDS

Abadco, Douglas L.; Amaro-Galvez, Rodolfo; Rao, Madu; Steiner, Phillip

doi:10.1001/archpedi.1992.02160210058021

Cited by 12 publications

(4 citation statements)

References 27 publications

(5 reference statements)

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“…It is also used clinically to diagnose and assess treatment response in various pulmonary diseases [3,4]. With the invention of smaller flexible bronchoscopes in recent years, a growing number of studies have investigated bronchoalveolar lavage constituents in children [5][6][7][8][9][10][11][12][13][14]. Most of these studies have focused on the retrieval of infectious organisms in the immunocompromised host.…”

mentioning

confidence: 99%

Differential cytology of bronchoalveolar lavage fluid in normal children

Ratjen¹,

Bredendiek²,

M³

et al. 1994

Eur Respir J

122

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We have studied the differential cytology of BAL fluid in 48 children aged 3-16 years (mean age±SD 7.9±3.5 yrs) undergoing elective surgery for nonpulmonary illnesses. A flexible bronchoscope (Pentax 3.5 or 4.9 mm) was wedged in the middle lobe or one of its segments. BAL was performed with 3×1 ml·kg -1 body weight of normal saline warmed to body temperature. The first sample was studied separately; subsequent samples were pooled for analysis.The mean recovery was 58±15%. Significantly more granulocytes and less lymphocytes were found in the first, as compared to the pooled, sample. Total cell counts were highly variable and ranged from 0.5-57.1 × 10 4 ·ml -1 . Macrophages were the predominant cell type, with a mean percentage of 81.2±12.7%. The relative proportion of lymphocytes was higher than that reported in most studies of adult volunteers (16.1±2.4%). No age dependency was observed for either cell type. The mean percentage of granulocytes was 2.5±3.3%. Absolute granulocyte counts were significantly higher in children under 8 yrs of age.This study provides the first reference data on BAL differential cytology in children without pulmonary disease and will be the basis for future investigations of BAL in paediatric lung diseases.

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mentioning

confidence: 99%

Differential cytology of bronchoalveolar lavage fluid in normal children

Ratjen¹,

Bredendiek²,

M³

et al. 1994

Eur Respir J

122

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“…El LBA se ha usado ampliamente en el diagnóstico de las infecciones pulmonares [5][6][7][8] , pero su sensibilidad y especificidad varían en función de que se trate de un enfermo inmunocompetente, o no, del microorganismo causal, de la técnica empleada y de la utilización, o no, de antibioterapia previa.…”

Section: Infecciones Pulmonaresunclassified

“…Es una de las principales aplicaciones del LBA en la infancia 2 , con un alto rendimiento diagnóstico (alrededor del 80 %) 5,8 .…”

Section: Niños Inmunocomprometidosunclassified

Técnicas fibrobroncoscópicas especiales: lavado broncoalveolar, biopsia bronquial y biopsia transbronquial

Montaner

Moreno‐Galdó

2005

Anales de Pediatría

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“…1 Flexible ®beroptic bronchoscopy with bronchoalveolar lavage (BAL) is a safe and effective method for diagnosing pulmonary infections in immunocompromised children. 2,3 Whereas BAL cellular results (lymphocytic or neutrophilic alveolitis) have a relatively low diagnostic yield in adults with AIDS-related pulmonary disease and in children, 4±9 BAL differential cell counts can reliably predict the outcome of patients with human immunode-®ciency virus type 1 (HIV-1) infections and pulmonary involvement. 10±13 For example, the ®nding of BAL neutrophilia in HIV-1-infected patients with opportunistic infections correlates strongly with an increased risk of death.…”

Section: Introductionmentioning

confidence: 99%

Cellular and noncellular components of bronchoalveolar lavage fluid in HIV‐1‐infected children with radiological evidence of interstitial lung damage*

Midulla

Strappini

Sandström

et al. 2001

Pediatric Pulmonology

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Children with acquired immune deficiency syndrome (AIDS) commonly have recurrent infectious and noninfectious lung complications that ultimately end in death. To study the intensity of alveolar inflammation and to evaluate the clinical utility of bronchoalveolar lavage (BAL) in children with HIV-1 infections, we retrospectively analyzed differential cell counts, lymphocyte subsets, and fibronectin and hyaluronic acid concentrations in BAL fluid of 18 HIV-1-positive children (9 boys, mean age 3.5 years, range 5 months-8 years) with radiological evidence of interstitial lung disease, and 19 control children who had undergone BAL for clinical indications not involving the lung parenchyma (13 boys, mean age 3 years, range 2 months-14 years). BAL fluid from 89% of the HIV-1 infected children showed CD8+ve lymphocytic alveolitis expressing HLA-DR, CD54, and CD 69 antigens. BAL fluid from HIV-infected patients typically contained markedly increased percentages and numbers of lymphocytes (P < 0.0001) and eosinophils (P < 0.04) and significantly higher concentrations of albumin (P < 0.05) and fibronectin (P < 0.0006) than fluids from control children. Whereas BAL cellular components did not differ in P. carinii-positive and P. carinii-negative HIV-1-infected children, fibronectin concentrations were significantly higher in P. carinii-positive than negative children. BAL cell differentials and noncellular components were related neither to severity of disease nor to patients' disease progression. These findings indicate that BAL is useful in studying the intensity of lung inflammation in children with HIV-1 infections and radiologically documented interstitial lung disease, but provides no information on the subsequent clinical course.

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Experience With Flexible Fiberoptic Bronchoscopy With Bronchoalveolar Lavage as a Diagnostic Tool in Children With AIDS

Cited by 12 publications

References 27 publications

Differential cytology of bronchoalveolar lavage fluid in normal children

Differential cytology of bronchoalveolar lavage fluid in normal children

Técnicas fibrobroncoscópicas especiales: lavado broncoalveolar, biopsia bronquial y biopsia transbronquial

Cellular and noncellular components of bronchoalveolar lavage fluid in HIV‐1‐infected children with radiological evidence of interstitial lung damage*

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