ABSTRACT
Background: wheezing is very common in children and more than 50% of children wheeze at some time during the first 6 years of their lives most of these infants will suffer from a single episode of wheezing, some of them showing recurrent and/or persistent wheezy chest. The differential diagnosis of recurrent/persistent wheeze is broad use of Flexible fiberoptic bronchoscopy [FFB] and bronchoalveolar lavage [BAL] are two promising new techniques .for diagnosing the etiology of recurrent/persistent wheezing
Aim of work: aim of this study is to assess the utility of FFB and BAL for diagnostic evaluation of young children with recurrent/persistent wheeze, not in acute attack, and to study the microbiological diagnostic yield of BAL and study the pattern of airway inflammation occurring in such children in Sohag University Hospital
Patients and methods: the study was conducted on 40 infants and children with recurrent/ persistent wheezy chest attending Sohag Faculty of Medicine - pediatric department and clinic and who are not in acute exacerbation or on antibiotic therapy, aged from > I month to < 60 months compared with10 children who are of similar ages as those in the patient group and who need FFB for indications other than recurrent /persistent wheezing which included as control group
Results: the BAZ cell profile of young children with wheezing typically includes a significantly higher cell count [mean, 701.50+/-423.46x 10[3]/ml],a significantly higher neutrophil count [55.43+/-60.09 p value 0.001], as compared with control subjects. Bacteriological culture findings were positive in 16 of the 30 children with wheezing [53.3%] and negative in 14 children [46.7%]. Wheezy children had measured higher level of LLMI, serum IgE and BAL [LTC4/D4/E4] when compared to controls [p=0.001]
Conclusion: FFB and BAL is safe and valuable diagnostic and therapeutic too1 for the management of preschool children with recurrent wheezing poorly responsive to treatement. A neutrophil mediated inflammation seems to characterize this young group of preschool wheezers