Document 0482
 DOCN  M9590482
 TI    Differential cell count and lymphocyte subsets in bronchoalveolar lavage
       during pneumonia with and without peripheral neutropenia.
 DT    9509
 AU    von Eiff M; Schlingheider O; Schulze F; Zuhlsdorf M; van de Loo J;
       Department of Internal Medicine, University of Munster, Federal;
       Republic of Germany.
 SO    Lung. 1995;173(1):25-33. Unique Identifier : AIDSLINE MED/95295356
 AB    One hundred immunocompromised HIV negative patients with
       microbiologically positive pneumonia underwent bronchoalveolar lavage
       (BAL) studies. Thirty cases showed peripheral neutropenia (< 1000
       neutrophils/microL), 70 did not. The total cell number in BAL, the
       differential cell counts, and the lymphocyte subsets (CD4, CD8, CD19,
       CD57) were measured. Patients with pneumonia and normal or elevated
       peripheral neutrophils had a significantly increased total number of
       cells in BAL compared to patients with peripheral neutropenia (3.2 +/- 2
       vs 1.3 +/- 0.6 x 10(5) cells/ml2 lavage fluid, p < 0.01). Ninety percent
       of the BAL differential cell counts obtained in patients exceeding 1000
       neutrophils/microL showed a lymphocytic and/or neutrophilic alveolitis,
       whereas only 54% of patients with peripheral neutropenia displayed
       abnormal counts (p < 0.01). Yet the typical pattern of neutrophilic
       alveolitis was found more often for peripheral neutrophil counts over
       1000/microL with high significance (p < 0.0001). Abnormal BAL cell
       patterns for neutropenic patients uniformly showed a lymphocytic
       alveolitis, only 10% additionally conformed with the pattern of
       neutrophilic alveolitis. Patients with pneumonia with and without
       peripheral neutropenia had similar findings in BAL lymphocyte subsets
       and exhibited a reduced CD4/CD8 ratio compared to controls (p < 0.05).
       The high susceptibility of severe neutropenic patients to pulmonary,
       especially fungal infections may be explained by the local lack of
       neutrophils.
 DE    Adolescence  Adult  Aged  Biopsy  Bronchoalveolar Lavage
       Fluid/*IMMUNOLOGY  Female  Human  HIV Seronegativity/IMMUNOLOGY  Immune
       Tolerance/IMMUNOLOGY  Lung/IMMUNOLOGY/PATHOLOGY  Lung Diseases,
       Fungal/*IMMUNOLOGY/PATHOLOGY  Lymphocyte Count  Lymphocyte
       Subsets/*IMMUNOLOGY  Male  Middle Age  Neutropenia/*IMMUNOLOGY
       Neutrophils/IMMUNOLOGY  Opportunistic Infections/*IMMUNOLOGY  Pneumonia,
       Bacterial/*IMMUNOLOGY/PATHOLOGY  Support, Non-U.S. Gov't  JOURNAL
       ARTICLE

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