THE DIAGNOSTIC-VALUE OF BRONCHOALVEOLAR LAVAGE IN IMMUNOCOMPETENT CHILDREN WITH CHRONIC DIFFUSE PULMONARY-INFILTRATES

We have investigated the diagnostic value of (BAL) in 29 immunocompete nt children (ages 1 month to 18 years) with chronic diffuse pulmonary infiltrates on chest radiograph who presented for evaluation over a 3- year period. The median age at the time of the BAL was 20 months with a range or 1-210 months. Positive results (1) diagnostic of a primary disorder; (2) consistent with a diagnosis; or (3) diagnostic of a seco ndary disorder, were obtained in 20/29 patients (13 with a single posi tive BAL finding and 7 with more than one finding). BAL was diagnostic of a primary disorder in only 5 patients (17%) with aspiration detect ed in 3 and infection in 2. The differential diagnosis was narrowed in 15 patients by the presence of lymphocytosis, neutrophilia, or eosino philia. A secondary disorder was uncovered in 8 patients. Negative res ults were obtained in 9 additional patients. We conclude that BAL prov ided useful information in children with chronic diffuse infiltrates, but its ability to determine the primary cause was limited. (C) 1997 W iley-Liss, Inc.