Bronchoalveolar Lavage Cellularity between Classic Asthma with Wheezing and Viral Associated Wheeze in Children

Kim, Chang Keun; Chung, Churl Young

Abstract

PURPOSE
Many young children with no other asthma features have episodic wheezing that is triggered solely by viral respiratory infections. We investigated the differential cytology in an effort to determine whether significant differences in bronchoalveolar lavage(BAL) cellularity to the pathophysiology of wheezing exist between classic astham(CA) and viral associated wheeze(VAW) in children.
METHODS
Bronchoscopy with BAL was performed on 44 children, 6 months and 15 years old: 12 CA, 13 VAW. 13 viral pneumonia(VP), and 6 control cases. Viral cultures were carried out. Differential cell counts were determined on cytospin slide stained with May Grunwald Giensu.
RESULTS
Total BAL fluid recovered was similar in all group(37+/-2.5%, mean+/-SEM) No significant differences in the total cell counts were observed among the four groups. Compared with the control, newtrophil percentages of VAW and VP(38.6+/-7.1% and 42.4+/-6.9%, respectively) were significantly(P<0.05) elevated than those of VAW and VP(2.0+/-0.1% and 0.4+/-0.3%, respectively). All cell types did not differ significantly between VAW and VP. The blood totol cosinophil counts were correlated with the BAL eosinophil percentage levels(r-0.795, P=0.0000).
CONCLUSIONS
In conclusion, neutrophils were prominent in children with viral associated wheeze, as eosinophils in those with classic asthma. Thses findings suggest that there are different implications of cell types for the pathophysiology in these two diseases.