Yield of bronchial forceps biopsies in addition to nasal brushing for ciliary function analyses in children.

BACKGROUND

The diagnosis of primary ciliary dyskinesia (PCD) is unlikely, if ciliary beat frequency (CBF) is normal. The aim of this study was to test the diagnostic value of an additional bronchial biopsy in cases where nasal CBF are abnormal.

PATIENTS, METHODS: In a paediatric bronchitis population nasal brush biopsies and bronchial forceps biopsies were taken. In both samples we measured CBF and compared results to nasal CBF of infants and children without respiratory disease.

RESULTS

Patients with bronchitis (n = 31; 0.3 to 14.6 years; 10 girls) had a normal CBF in their nasal biopsies in 68 %, and in bronchial biopsies in 48 %, compared to the reference group (n = 72; 0.5 to 17.5 years; 23 girls). One patient had an abnormal nasal, but a normal bronchial ciliary activity. When cilia were beating at both sites (n = 14), nasal CBF agreed well with bronchial CBF (mean difference -0.78 Hz, 95 % confidence interval -1.81 Hz to 0.25 Hz).

CONCLUSIONS

By adding the investigation of bronchial mucosa to the measurement of nasal CBF the diagnostic yield to exclude PCD was only improved from 68 % to 71 %. Consequently, if nasal ciliary activity is abnormal in infants and children with bronchitis, we do not recommend additional bronchoscopy to obtain another biopsy.