Introduction: Increased eosinophil count in sputum is characteristic of atopic asthma in school-children. Less is known regarding the occurrence of eosinophils in broncho-alveolar lavage fluid (BALF) of infants and toddlers with recurrent wheezing and their additional value for diagnosing asthma.
Aim: to investigate the occurrence of eosinophilia in the BALF of young children (less than 4 years) with asthmatic.
Methods: Consecutive children aged 0-4 years that underwent flexible bronchoscopy and broncho-alveolar lavage were enrolled. In all, BALF differential cell count was studied. Patients were assigned retrospectively into one of three groups: asthma, anatomic upper airway obstruction and lung diseases other than asthma.
Results: 83 children were included. Mean age was 19 months (range 1-48). 27 were diagnosed with asthma, 13 had upper airway obstruction and 43 suffered from a variety of other lung diseases. Groups did not differ in age or gender. No significant difference was found between the groups for any of BALF cell types. Eosinophil counts were very low in all groups, median and interquartile range: 0% (0-0.3), 0% (0-0.55) and 0.4% (0-0.9) in the asthma group, upper airway obstruction and the group of other lung diseases, respectively. Only one child with wheezing that subsequently developed asthma had abnormally high (10.8%) eosinophil count.
Conclusion: unlike school-children, asthma in young children is not associated with increased BALF eosinophil count. Hence, the yield of eosinophil count in BALF for diagnosing asthma in young children with clinical presentation suggesting asthma is low.
