The investigations were carried out on 23 children (median age: 6.7 yrs; range: 1.7-12.75 yrs), attending the Royal Belfast Hospital for Sick Children for elective surgery, who also had a chronic unexplained cough. Written informed consent was obtained from the parent(s) and a nonbronchoscopic BAL was performed. BAL samples were analysed for total and differential white cell counts and also for the inflammatory mediators, eosinophil cationic protein (ECP) and histamine. Results were compared with a group of normal nonatopic children and also a group of atopic asthmatic children, who had been recruited for other studies on airway inflammation.
There was a small but statistically significant increase in BAL percentage eosinophils in the children with chronic cough compared with nonasthmatic controls (0.28% versus 0.10%, p=0.03). However, the children with cough had lower percentage eosinophils than the atopic asthmatic controls (0.28% versus 0.66%, p=0.01). Three out of 23 children with chronic cough had BAL eosinophils greater than the normal upper 95% reference interval in BAL. There was a small but statistically significant increase in percentage neutrophils in the children with cough compared with the nonasthmatic controls (5.85% versus 3.21%, p=0.03). Four out of the 23 children had BAL neutrophils greater than the normal upper 95% reference interval in BAL.
The authors conclude that only a minority of children with chronic unexplained cough have asthmatic-type airway inflammation. It is speculated that the increased percentage neutrophils in bronchoalveolar lavage from children with cough could relate to underlying persistent airways infection.
- Blood Proteins
- Diagnosis, Differential
- Leukocyte Count
- Child, Preschool
- Respiratory Tract Infections
- Bronchoalveolar Lavage Fluid
- Eosinophil Granule Proteins
- Inflammation Mediators
- Chronic Disease
- Respiratory Hypersensitivity
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Liam Heaney (Participant), Ian Cadden (Participant), Michael Shields (Participant), Madeleine Ennis (Participant), Bettina Schock (Participant), Vanessa Brown (Participant), Michael Ryan (Participant), Dennis Carson (Participant) & Timothy Warke (Participant)
Impact: Health Impact, Quality of Life Impact