title: Bronchoalveolar lavage cell analysis in a child with chronic lipid pneumonia.
abstract: In an asymptomatic 4 yr old child with radiographic evidence of parenchymal lung disease, bronchoalveolar lavage (BAL) yielded the diagnosis of chronic lipid pneumonia caused by chronic aspiration of mineral oil given as a laxative. BAL analysis showed a marked reduction in the total number of alveolar macrophages; almost 70% of these cells contained intracytoplasmic lipid vacuoles. It also disclosed lymphocytic (cytotoxic/suppressor) alveolitis. A high percentage of lymphocytes expressed antigen markers of activation (human leucocyte antigen (HLA)-DR), CD54 and CD25). BAL analysis 18 months after mineral oil intake revealed that lymphocytes bearing antigen markers of activation had markedly decreased whereas alveolar macrophages (normal and lipid-laden) had increased. A subsequent whole lung BAL was considered unnecessarily invasive in this otherwise healthy child.
authors.affiliation: IV Dept of Pediatrics, Institute of Pediatrics, University of Rome La Sapienza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Midulla
authors.forename: P M
authors.initials: PM
authors.lastname: Strappini
authors.forename: V
authors.initials: V
authors.lastname: Ascoli
authors.forename: M P
authors.initials: MP
authors.lastname: Villa
authors.forename: L
authors.initials: L
authors.lastname: Indinnimeo
authors.forename: C
authors.initials: C
authors.lastname: Falasca
authors.forename: S
authors.initials: S
authors.lastname: Martella
authors.forename: R
authors.initials: R
authors.lastname: Ronchetti
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D016131:Lymphocyte Subsets / Q000473:pathology; D008297:Male; D008899:Mineral Oil / Q000009:adverse effects / Q000627:therapeutic use; D011017:Pneumonia, Lipid / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemical_list: D002400:Cathartics; D008899:Mineral Oil