Chest
Clinical InvestigationsAsthmaBronchoalveolar Cells in Children < 3 Years Old With Severe Recurrent Wheezing
Section snippets
Materials and Methods
Demographic and clinical data were obtained by retrospective review of the patients’ medical records.
FB Findings
FB and BAL were well tolerated by children with wheezing and control subjects, and no major complications were observed. For the 83 children with wheezing, bronchoscopy results were normal in 36 children and mild airway inflammation (erythema) was detected in 43 children. Airway morphology was abnormal in the four remaining children with wheezing: slight laryngomalacia (n = 2) and moderate anterior compression of the trachea (n = 2). These four children were retained in the analysis because
Discussion
Little is known about cell profile in normal young children and in infants with recurrent wheezing (Table 2). This series of 83 infants with wheezing constitutes the largest reported. Our indications for bronchoscopy were very restrictive. In each case, bronchoscopy was used in search of airways abnormalities in children with severe recurrent wheezing, as recommended by other authors.1516 BAL was carried out according to the recommendations of the European Respiratory Society.14 One possible
Conclusion
This study was carried out with a large series of children with severe recurrent wheezing. The high level of neutrophils and the normal number of eosinophils in the BAL seem to be specific in children of this age group with severe respiratory symptoms. These features confirm the presence of inflammation outside an acute episode. This high level of neutrophils does not seem to be associated with the quality of collection or the presence of a bacterial or viral infection. Our results suggest that
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