ACTA FAC MED NAISS 2012;29(3):139-144

 Original article

UDC:616.24-002-072.1-053.2        DOI: 10.2478/v10283-012-0019-1

Lymphocyte Subsets in Bronchoalveolar Lavage Fluid of Children with Lung Infiltrates

Amina Selimović¹, Senka Mesihović Dinarević¹, Tatjana Pejčić², Ermina Mujičić³, Aida Hasanović⁴, Siniša Ristić⁵, Nataša Banjac⁶, Željko Pavlović⁷

¹Pediatric Clinic of the Clinical Centre of the University of Sarajevo, Bosnia and Herzegovina

²University of Niš, Faculty of Medicine, Serbia

³Cardiosurgery Department and Clinic for Anesthesiology and Reanimatology, Clinical Centre of the University of Sarajevo, Bosnia and Herzegovina

⁴University of Sarajevo, Faculty of Medicine, Bosnia and Herzegovina

⁵University of East Sarajevo, Faculty of Medicine in Foča, Bosnia and Herzegovina

⁶Microbiology Department, Hospital Kasindo East Sarajevo, Bosnia and Herzegovina

⁷Emergency Centre, Hospital Kasindo East Sarajevo, Bosnia and Herzegovina


sUMMARY

The analysis of the subpopulation of lymphocytes - CD4+, CD8+ lymphocytes in bronchoalveolar lavage (BAL) of paediatric patients can provide useful information related the lung parenchyma. The aim of the paper was to analyze the results of bronchoscopy of patients presenting with persistent lung infiltrates and to find out of the diagnostic yield and complication rate of this procedure. The study is a retrospective one. The data related to paediatric findings and BAL results of the bronchoscopies were retrieved from the hospital records. BAL was performed in tracheobronchial airways (middle lobe) by bronchoscope and sent to analysis of CD4+, CD8+ lymphocytes. Bronchoscopy was performed under general anesthesia (sedation, propofol, midazolam, morphium). The records of seven patients were analyzed. All patients presented with persistent lung infiltrate (atelectasis and pneumonia). 71% of the patients with lung infiltrates in our study were below the age of 5. Our study results showed that CD4+, CD8+ lymphocytes in BAL in the studied group showed a small percentage of CD8+ lymphocytes as an immune response in 8-10% of patients, while the cellular response of CD4 +lymphocytes in the sample itself was present up to 14% in the entire group of the diseased children. There was no serious desaturation during bronchoscopy. Bronchoscopy with BAL findings of lymphocyte populations is important in the early identification of inflammation and it helps in therapeutic strategies and monitoring of inflammatory response to the given therapy.

Key words: flexible bronchoscopy with BAL, CD4+, CD8+ lymphocyte, lung infiltrate