title: Investigation of children with chronic nonspecific cough: any clinical benefit of bronchoscopy and bronchoalveolar lavage?
abstract: Chronic cough can be a complicated and frustrating diagnostic dilemma. The aim of this study was to identify the possible causes of chronic nonspecific cough in seemingly healthy children using fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL). Eighteen children responded to criteria of selection for chronic cough. The average age was 5.8 years (range, 1.7-10.7 years) and BAL findings were compared with those of 16 nonatopic controls. Children with chronic cough had an increased percentage of BAL neutrophils in comparison with the control group (p = 0.098). Using a BAL neutrophil percent cutoff of 17%, 6 children had high BAL neutrophils (HBNs; median, 77%; range, 27-96%) and 12 children had normal BAL neutrophils (NBNs; median, 3%; range, 0-13%). In the HBN group, FOB showed endoscopic abnormalities in four patients, BAL culture was positive in three patients, and chest x-ray (CXRs) showed minimal densities in four. The IL-8 levels showed a significant increase with respect to the NBN group (p = 0.005). The combination of endoscopic anomalies, BAL culture, BAL IL-8 levels, and minor CXR changes can support the diagnosis of subclincal infection in seemingly healthy children with chronic nonspecific cough and HBN.
authors: Department of Paediatrics, University of Padova, Padova, Italy.
authors: Deborah
authors: D
authors: Snijders
authors: Andrea
authors: A
authors: Cattarozzi
authors: Cristina
authors: C
authors: Panizzolo
authors: Vincenzo
authors: V
authors: Zanardo
authors: Graziella
authors: G
authors: Guariso
authors: Fiorella
authors: F
authors: Calabrese
authors: Diego
authors: D
authors: Faggian
authors: Carlamaria
authors: C
authors: Monciotti
authors: Angelo
authors: A
authors: Barbato
mesh_terms: D018893:Bronchoalveolar Lavage / Q000592:standards*; D001999:Bronchoscopy / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003371:Cough / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D013902:Radiography, Thoracic; D012189:Retrospective Studies
chemical_list: D016209:Interleukin-8