Document Detail

Induced sputum versus bronchoalveolar lavage during acute chest syndrome in sickle cell disease.
MedLine Citation:
PMID:  12969866     Owner:  NLM     Status:  MEDLINE    
Previous reports have shown that in more than 40% of adults with acute chest syndrome (ACS), fat droplets suggestive of pulmonary fat embolism were present in alveolar macrophages. To determine whether induced sputum (IS) is a reliable test for detecting this embolism, we compared bronchoalveolar lavage and IS results in 20 patients with ACS. We found a correlation between the number of Oil Red O-stained macrophages in sputum and lavage fluid (Spearman's coefficient: rho = 0.657, p < 0.018). Sputum cytology was then studied in another 60 patients who had sickle cell disease with ACS. An elevated percentage of Oil Red O-stained macrophages was found in the sputum of 37/47 patients, but they did not include any of the patients with sickle cell disease but no clinical symptoms. Patients suffering from ACS with Oil Red O-stained macrophages had more extrathoracic concomitant pain than those without (76 vs. 50%, p < 10-8), had more neurologic symptoms (7 vs. 0%, p < 10-8), a lower differential platelet count (-49 +/- 121 vs. +85 +/- 229, p < 0.04), and higher abnormal transaminase values (28 vs. 17%, p < 0.01). We conclude that IS analysis is a safe, noninvasive, and useful test for fat embolism detection in ACS.
Emmanuelle Lechapt; Anoosha Habibi; Dora Bachir; Frederic Galacteros; Annette Schaeffer; Dominique Desvaux; Laurent Brochard; Bruno Housset; Bertrand Godeau; Bernard Maitre
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2003-09-11
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  168     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-01-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1373-7     Citation Subset:  AIM; IM    
Department of Pathology, Sickle Cell Disease Center, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Inserm U492, Université Paris XII, Créteil, France.
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MeSH Terms
Acute Disease
Anemia, Sickle Cell / complications*,  pathology
Bronchoalveolar Lavage Fluid / cytology*
Embolism, Fat / etiology,  pathology*
Macrophages, Alveolar / pathology*
Pulmonary Embolism / etiology,  pathology*
Reproducibility of Results
Sputum / cytology*

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

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