title: The diagnostic value of bronchoalveolar lavage in immunocompetent children with chronic diffuse pulmonary infiltrates.
abstract: We have investigated the diagnostic value of (BAL) in 29 immunocompetent children (ages 1 month to 18 years) with chronic diffuse pulmonary infiltrates on chest radiograph who presented for evaluation over a 3-year period. The median age at the time of the BAL was 20 months with a range of 1-210 months. Positive results (1) diagnostic of a primary disorder; (2) consistent with a diagnosis; or (3) diagnostic of a secondary disorder, were obtained in 20/29 patients (13 with a single positive BAL finding and 7 with more than one finding). BAL was diagnostic of a primary disorder in only 5 patients (17%) with aspiration detected in 3 and infection in 2. The differential diagnosis was narrowed in 15 patients by the presence of lymphocytosis, neutrophilia, or eosinophilia. A secondary disorder was uncovered in 8 patients. Negative results were obtained in 9 additional patients. We conclude that BAL provided useful information in children with chronic diffuse infiltrates, but its ability to determine the primary cause was limited.
authors.affiliation: Pediatric Pulmonary Section, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Fan
authors.forename: M C
authors.initials: MC
authors.lastname: Lung
authors.forename: J S
authors.initials: JS
authors.lastname: Wagener
mesh_terms: D000293:Adolescent; D001706:Biopsy; D018893:Bronchoalveolar Lavage; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis*; D011446:Prospective Studies