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Neutrophils or Eosinophils in Young Children With Wheezing : Which Comes First?

Michelle M. Cloutier, MD
Author and Funding Information

Affiliations: Hartford, CT
 ,  Dr. Cloutier is Professor of Pediatrics, University of Connecticut Health Center, and Director, Asthma Center and Easy Breathing, Connecticut Children’s Medical Center.

Correspondence to: Michelle M. Cloutier, MD, Professor of Pediatrics, Connecticut Children’s Medical Center, 282 Washington St, Hartford, CT 06106; e-mail: mclouti@ccmckids.org



Chest. 2002;122(3):761-763. doi:10.1378/chest.122.3.761
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In this issue of CHEST (see page 791), Le Bourgeois and colleagues from Hôpital Necker- Enfants Malades in Paris, France describe the BAL cell profiles of 83 young children aged 4 to 32 months with wheezing. These children were identified retrospectively from a bronchoscopy database. All children had had recurrent wheezing associated with at least monthly oral corticosteroid therapy and had poorly responded to inhaled corticosteroid therapy. BAL was performed at least 15 days after an acute exacerbation and at least 15 days after a short course of oral steroids. Viral cultures were obtained in two thirds of the wheezing children, and bacterial cultures were obtained in one third of the wheezing children. Positive viral culture findings were found in 9 of the infants, and positive microbiologic culture findings were found in 18 of the infants; thus, 41% of the children tested had either a positive viral or a positive microbiologic culture finding (assuming no overlap). Seventeen children with nonwheezing pulmonary diseases were used as control subjects. Compared to these control children, the authors found an increased cell count and an increased percentage and absolute neutrophil count in infants with wheezing regardless of the presence of bacteria and/or viruses. The authors also found a low number and percentage of eosinophils, with no difference between children with wheezing and control subjects.

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