Pourakbari Babak, Mahmoudi Shima, Jafari Amir Hossein, Bahador Abbas, Keshavarz Valian Sepideh, Hosseinpour Sadeghi Reihaneh, Mamishi Setareh
Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Microb Pathog. 2016 Nov;100:179-183. doi: 10.1016/j.micpath.2016.09.014. Epub 2016 Sep 22.
Diffuse lung diseases (DLD) in children involve a group of heterogeneous, rare disorders. In spite of the low diagnostic yield in pediatric DLD, bronchoalveolar lavage (BAL) can be used to diagnose specific disorders. There are few studies about microbial and cellular profiles of BAL samples in these patients. This study was conducted to evaluate the clinical, cytological and microbiological evaluation of BAL in children with DLD.
The clinical, cytological and microbiological profiles of BAL samples of all patients with DLD who underwent the fiberoptic bronchoscopy (FOB) at Children's Medical Center, an Iranian referral pediatrics Hospital during a year were evaluated.
In 18 patients (18.4%) of the 98 cases studied, 22 pathogens were obtained as etiologic agents. The mean total cells count of BAL was 23.9 × 104 ± 12.9 × 104/ml. The mean percentages of cellular components were macrophages (70.2%), neutrophils (16.3%), lymphocytes (11.8%) and eosinophils (1.4%), respectively. The type of lung disease was significantly associated with the mean percentage of lymphocytes (p = 0.005) and the percentage of neutrophils (p = 0.042).
FOB and BAL evaluation in combination with clinical and radiographic imaging data may be helpful for identifying of presumptive diagnosis of DLD in children.
儿童弥漫性肺疾病（DLD）是一组异质性罕见疾病。尽管儿科DLD的诊断率较低，但支气管肺泡灌洗（BAL）可用于诊断特定疾病。关于这些患者BAL样本的微生物和细胞特征的研究较少。本研究旨在评估DLD患儿BAL的临床、细胞学和微生物学情况。
对伊朗一家转诊儿科医院儿童医学中心一年内接受纤维支气管镜检查（FOB）的所有DLD患者BAL样本的临床、细胞学和微生物学特征进行评估。
在研究的98例病例中，18例（18.4%）患者检出22种病原体作为病因。BAL的平均总细胞计数为23.9×10⁴±12.9×10⁴/ml。细胞成分的平均百分比分别为巨噬细胞（70.2%）、中性粒细胞（16.3%）、淋巴细胞（11.8%）和嗜酸性粒细胞（1.4%）。肺病类型与淋巴细胞的平均百分比（p = 0.005）和中性粒细胞百分比（p = 0.042）显著相关。
FOB和BAL评估结合临床和影像学数据可能有助于确定儿童DLD的初步诊断。
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