Document Detail

Blood eosinophil counts rarely reflect airway eosinophilia in children with severe asthma.
MedLine Citation:
PMID:  23347007     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The inflammatory phenotypes of severe asthma in adults may be reflected in peripheral blood. If this were true in children with severe therapy-resistant asthma (STRA), invasive tests could be avoided. At the moment there is no conclusive evidence in children.
METHODS: All patients underwent blood tests, exhaled nitric oxide (FeNO), sputum induction, bronchoalveolar lavage (BAL) and endobronchial biopsy (EB).
RESULTS: Sixty-three (71.6%) patients had a normal blood profile and only 1/88 had a combined blood eosinophilia and neutrophilia. 76/88 (86%) had normal blood eosinophils, but of these, 84% had airway eosinophilia in either BAL (n = 43;66%) or EB (n = 41;79%). In children with STRA blood eosinophilia was associated with airway eosinophilia. However, normal blood eosinophil levels did not exclude airway eosinophilic inflammation.
CONCLUSIONS: Peripheral blood counts are not reliable in characterising airway inflammation in severe asthmatic children exposed to high dose steroid therapy, therefore bronchoscopy with BAL should be considered.
N Ullmann; C J Bossley; L Fleming; M Silvestri; A Bush; S Saglani
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-25
Journal Detail:
Title:  Allergy     Volume:  68     ISSN:  1398-9995     ISO Abbreviation:  Allergy     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-12     Completed Date:  2013-08-01     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  402-6     Citation Subset:  IM    
Copyright Information:
© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
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MeSH Terms
Asthma / complications*,  diagnosis*
Bronchoalveolar Lavage Fluid / immunology
Eosinophilia / complications*
Leukocyte Count
Grant Support
083586/Z/07/Z//Wellcome Trust; MR/J010529/1//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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