Determination of the inflammatory component of airway diseases by induced sputum cell counts: use in clinical practice.
OBJECTIVE
To evaluate the usefulness of determining the inflammatory component of airway diseases (inflammometry) by induced sputum cell counts, as well as its influence on treatment decisions in a tertiary facility for the treatment of respiratory diseases.


METHODS
We analyzed 151 sputum samples from 132 consecutive patients referred for clinical sputum induction by five pulmonologists between July of 2006 and February of 2007. A structured questionnaire related to the reasons for requesting the test and to the therapeutic decision making based on test results was completed by each attending physician upon receiving the test results. Induced sputum was obtained and processed according to a technique previously described.


RESULTS
The principal motives for ordering the test were inhaled corticosteroid dose titration in patients with moderate-to-severe asthma (in 54.3%), investigation of chronic cough (in 30.5%), and monitoring airway inflammation in patients with bronchiectasis (in 7.3%) or chronic obstructive pulmonary disease (in 6%). Of the 82 patients with asthma, 47 (57%) presented eosinophilic bronchitis (>3% eosinophils). Nonasthmatic eosinophilic bronchitis was diagnosed in 9 (19%) of the 46 patients with chronic cough. Neutrophilic bronchitis (>65% neutrophils) was found in 13 patients, of which 5 had asthma, 2 had chronic cough, and 6 had chronic obstructive pulmonary disease/bronchiectasis. Based on the induced sputum results, the corticosteroid dose was modified in 48 asthma patients (64.7%).


CONCLUSIONS
The systematic application of inflammometry using induced sputum cell counts can be beneficial for patients with airway diseases, particularly those with asthma or chronic cough.
Moritz
Pablo
P
Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
Steidle
Leila John Marques
LJ
Felisbino
Manuela Brisot
MB
Kleveston
Túlia
T
Pizzichini
Marcia Margaret Menezes
MM
Pizzichini
Emilio
E
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D001987:Bronchiectasis / Q000175:diagnosis / Q000188:drug therapy; D001991:Bronchitis / Q000175:diagnosis* / Q000188:drug therapy; D002452:Cell Count; D002985:Clinical Protocols; D003371:Cough / Q000188:drug therapy / Q000209:etiology; D003430:Cross-Sectional Studies; D003948:Diagnostic Techniques, Respiratory System; D004802:Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy; D013183:Sputum / Q000166:cytology* / Q000378:metabolism; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones