Exploring associations of lower airway lymphocytosis and mucosal cobblestone appearance in children undergoing flexible bronchoscopy

Abstract

Introduction/Aim: Lower airway lymphocytosis and cobble-stoning are common findings in children undergoing flexible bronchoscopy (FB). However, to date there are no paediatric studies that have explored possible associations with these findings. Thus, using our dataset of 242 children, we explored possible associations between lymphocytosis found in the bronchoalveolar lavage (BAL) and cobblestoning of mucosa seen at FB. Methods: Our database consisted of 242 children with BAL data; 100 were consecutive FB recordings retrospectively screened and 142 children prospectively collected. We excluded FBs if: BAL data was unavailable, incomplete FB recording or FBs were on children who were immune-compromised or had endotracheal tube, tracheostomy or foreign body. Pearson's χ2 test was used for the categorical variables and logistic regression was used to calculate odds ratio and 95% CI. Univariate and multivariate analysis were carried out of potential risk factors for BAL lymphocytosis (>15%) and for cobblestoning including whether viruses were present or not, whether bacteria (≥10E4 cfu/ml BAL) were present or not, whether viruses and bacteria were present or not, age, gender and BAL eosinophilia. Here we report our preliminary findings. Results: Lymphocytosis and mucosa cobblestoning were common, occurring in 66 (27%) and 61 (25%) children respectively. Univariate and multivariate analyses did not identify any significant associations for lymphoctyosis (table 1). Specifically, the presence of any virus had OR of 0.69 95%CI 0.38-1.26). For mucosa cobblestoning, the sole significant association was age < 24-mo (compared to >24-mo) (Table 1) Conclusion: Mucosal cobblestoning is more common in younger children aged <2 years. The importance of the common occurrence of lower airway lymphocytosis and mucosal cobblestoning requires further exploration.L6269395482019-04-02 <br />