Use of nasal cytology in the diagnosis of occult chronic sinusitis in asthmatic children.

BACKGROUND: Chronic sinusitis, in contrast to acute sinusitis, often presents with nonspecific symptoms that may be confused with other disease entities. Due to the cost of computerized tomography and the difficulty in interpreting sinus radiographs in certain children, a search for a simpler screening tool for chronic sinusitis in children was undertaken. OBJECTIVE: This study was undertaken to provide a quantitative comparison between the methods of wax paper blow and Rhinoprobe scraping for nasal cytology in screening for chronic sinusitis while minimizing selection bias. METHODS: Twenty serially selected patients (13 males and seven females) with a mean age of 11 years (range 6-16) were enrolled. Nasal cytology was obtained via two methods: scraping of the turbinate with a Rhinoprobe (Synbiotics Inc.,) and wax paper blow. RESULTS: The results showed that > or = 5 neutrophils per high power field on Rhinoprobe cytology significantly correlated with radiographic sinusitis (P < .05 by Chi-square and P < .056 by Fisher's exact test). The sensitivity and specificity for > or = 5 neutrophils per high power field were 100% and 53%, respectively. Counts of other nasal cells, such as eosinophils, bacteria, and epithelial cells, did not yield significant correlations with radiographic sinusitis. CONCLUSIONS: We feel that the Rhinoprobe, with criteria of > or = 5 neutrophils per high power field, may be useful as a screen for occult chronic sinusitis in childhood asthma. Confirmation of sinusitis via X-ray is still necessary if neutrophils are present on Rhinoprobe nasal cytology.

Use of laser nephelometry in the measurement of specific antibody to lamb's quarters antigen.

Laser nephelometry was used to measure specific antibody to lamb's quarters antigen. It was demonstrated that the same specific antibody detected by indirect hemagglutination could readily be measured by this sensitive technique. Current investigations are being conducted to determine if this system might be validated for the measurement of blocking antibody in human serum.

Distribution of peripheral blood T and B lymphocyte markers in atopic children and changes during immunotherapy.

Peripheral blood lymphocytes from children undergoing evaluation for allergic disease were examined for T and B lymphocyte markers. Patients were evaluated at intervals to determine differences in these markers between atopic and nonatopic children and relative changes during immunotherapy. T lymphocytes were identified by the sheep RBC rosette technique. Surface immunoglobulin was detected by immunofluorescence following incubation with fluorescein-labeled antihuman IgG, IgA, IgM, and IgE. At initial examination, atopic patients differed from controls only in the increased percentage of lymphocytes bearing surface IgM. There were no differences between patient and control values in T lymphocyte distribution or in cells bearing surface IgG, IgA, or IgE at any point in the study. The increased percentage of IgM-bearing lymphocytes is reduced to the control level after four months of immunotherapy but remains elevated in the untreated atopic group. Serum IgM levels remained constant. This study shows that the distribution of lymphocyte markers may be altered in atopic children. Patients treated with immunotherapy demonstrated a return to control values of IgM-bearing lymphocytes. The elevated serum IgE seen in atopy was not reflected in an elevated percentage of IgE-bearing lymphocytes.

Distribution of T and B lymphocytes in lymphoid tissue of infants and children.

Normal lymphoid tissue from children undergoing elective surgery was examined for T and B lymphocyte distribution. Although established for peripheral blood and bone marrow, T and B lymphocyte distributions have not been previously reported for lymph nodes, appendix, thymus, and spleen tissues in children. Thymus-dependent T cells were determined by the sheep erythrocyte rosette technique, and thymus-independent B cells were determined by the fluorescent labeling of surface immunoglobulins A (IgA), G (IgG), and M (IgM). Fifty percent of lymph node cells were either T or B cells; 65% of these cells were T lymphocytes, whereas 58% of B cells were of the IgM subclass. Less than half of the appendix cells were either T or B cells; 47% of these were T lymphocytes, and the remainder B lymphocytes had subclass distribution similar to that of lymph nodes but different from peripheral blood and bone marrow where B cells bearing IgG predominate. Thymus tissue contained 43% T cells and less than 1% B cells, but the spleen was composed largely of B cells, predominantly of the IgM type. Lymphoid tissue from nine children with either inflammatory or neoplastic diseases were studied and included for contrast. This paper establishes relative distribution values for T and B lymphocytes in normal lymphoid tissue and points out the potential use of this technique to quantitate deviations from normal in certain inflammatory and neoplastic diseases.