Bronchoalveolar lavage in children with inflammatory and non inflammatory lung disease

Hippokratia 2010; 14 (2): 109-114

D. Gidaris, F. Kanakoudi – Tsakalidou, D. Papakosta, V. Tzimouli, A. Taparkou, M. Ventouri, I. Tsanakas


Background: Bronchoalveolar lavage (BAL) is a useful bronchoscopic technique. Studies in ?normal? children are limited.
Aim: To provide data on BAL reference values from Greek children and compare BAL cellular and noncellular components in children with inflammatory and non-inflammatory lung diseases.
Methods: Seventy two children, aged 2.5 months to 16 years, underwent diagnostic bronchoscopy and BAL. Patients were divided in two groups whether lung inflammation was absent or present. Differential cytology, flow cytometry for lymphocyte subsets and cytokine and chemokine measurements were performed on BAL fluid.
Results: Alveolar macrophages were the predominant cellular population in normal children. Patients with inflammatory pneumonopathies had significantly more neutrophils. There was no difference in lymphocyte subpopulations.Values of CD4+/CD8+ ratio in BAL was similar to that reported in adults. Levels of IL-8 and TNF- á were significantly higher in children with inflammatory lung diseases.
Conclusion: This study provides the first data on BAL of ?normal? Greek children. BAL from patients with pulmonary inflammation was characterised by neutrophilia. Finally, we propose that measurement of IL-8 and TNF-a levels in BAL could help in early identification of inflammation in the tracheobronchial tree.