Analysis of bronchoalveolar lavage samples collected from 30 patients with drug-induced pneumonitis.


Journal

Respiratory investigation
ISSN: 2212-5353
Titre abrégé: Respir Investig
Pays: Netherlands
ID NLM: 101581124

Informations de publication

Date de publication:
May 2020
Historique:
received: 17 07 2019
revised: 12 12 2019
accepted: 03 01 2020
pubmed: 3 3 2020
medline: 22 8 2020
entrez: 2 3 2020
Statut: ppublish

Résumé

Drug-induced pneumonitis is a disease encountered by pulmonologists in the clinical setting. The diagnosis generally considers the patient's clinical course and the results of peripheral blood tests, radiological examinations, and often bronchoscopic examinations. However, few studies have reported the association between radiological patterns such as ground-glass opacity (GGO) or consolidation, and bronchoalveolar lavage fluid (BALF) cell fractions. This study aimed to clarify this association. Patients with a Naranjo's score of probable or definite were enrolled, and all 30 patients were categorized under probable. Data such as patient background, blood examination results, radiological findings, and BALF cell fractions were retrospectively collected. The association between BALF cell fractions and other factors such as chest computed tomography (CT) findings was evaluated. The most common radiological finding in patients with lymphocyte-dominant BALF was GGO, with only one patient exhibiting consolidation. However, patients with eosinophil-dominant BALF were more likely to have consolidation; only three cases showed crazy paving and one showed GGO. In addition, patients with a GGO-dominant pattern on CT had an increased lymphocyte fraction of 41.0%; those with a consolidation-dominant pattern showed a relatively high eosinophil fraction of 5.2%; and those with a crazy paving pattern showed elevated eosinophil and neutrophil fractions of 19.1% and 9.9%, respectively. In this study, a remarkable difference in radiological findings was observed among different BALF patterns.

Sections du résumé

BACKGROUND BACKGROUND
Drug-induced pneumonitis is a disease encountered by pulmonologists in the clinical setting. The diagnosis generally considers the patient's clinical course and the results of peripheral blood tests, radiological examinations, and often bronchoscopic examinations. However, few studies have reported the association between radiological patterns such as ground-glass opacity (GGO) or consolidation, and bronchoalveolar lavage fluid (BALF) cell fractions. This study aimed to clarify this association.
METHODS METHODS
Patients with a Naranjo's score of probable or definite were enrolled, and all 30 patients were categorized under probable. Data such as patient background, blood examination results, radiological findings, and BALF cell fractions were retrospectively collected. The association between BALF cell fractions and other factors such as chest computed tomography (CT) findings was evaluated.
RESULTS RESULTS
The most common radiological finding in patients with lymphocyte-dominant BALF was GGO, with only one patient exhibiting consolidation. However, patients with eosinophil-dominant BALF were more likely to have consolidation; only three cases showed crazy paving and one showed GGO. In addition, patients with a GGO-dominant pattern on CT had an increased lymphocyte fraction of 41.0%; those with a consolidation-dominant pattern showed a relatively high eosinophil fraction of 5.2%; and those with a crazy paving pattern showed elevated eosinophil and neutrophil fractions of 19.1% and 9.9%, respectively.
CONCLUSIONS CONCLUSIONS
In this study, a remarkable difference in radiological findings was observed among different BALF patterns.

Identifiants

pubmed: 32113934
pii: S2212-5345(20)30007-1
doi: 10.1016/j.resinv.2020.01.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

204-211

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2020 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None of the authors has any conflict of interest to report.

Auteurs

Momoko Yamauchi (M)

Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan. Electronic address: yamamomo@nagasaki-u.ac.jp.

Shusaku Haranaga (S)

Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Gretchen Parrott (G)

Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Takeshi Kinjo (T)

Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Tsuneo Yamashiro (T)

Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Maho Tsubakimoto (M)

Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Hiroshi Ohtsu (H)

Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.

Shinichiro Ueda (S)

Department of Clinical Pharmacology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

Jiro Fujita (J)

Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.

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