Elsevier

The Journal of Pediatrics

Volume 129, Issue 6, December 1996, Pages 913-915
The Journal of Pediatrics

Cd1a-positive cells in bronchoalveolar lavage samples from children with Langerhans cell histiocytosis,☆☆,

https://doi.org/10.1016/S0022-3476(96)70038-0Get rights and content

Abstract

We evaluated CD1a-positive cells in bronchoalveolar lavage samples from children with Langerhans cell histiocytosis (LCH). All children with multifocal LCH and pulmonary symptoms scored higher than 5% (30.6% ± 7.2%), whereas those with other lung disorders scored much less than 5%. In children with multifocal LCH, bronchoalveolar lavage fluid abnormalities can precede pulmonary symptoms. During chemotherapy the CD1a-positive cell count tends to decrease. (J Pediatr 1996;129:913-5)

Section snippets

Patients

Forty-three BAL procedures were performed in 18 children between 2 months and 7 years of age with LCH and 61 BAL procedures in 60 children between 1 month and 15 years of age with miscellaneous lung disorders (control group). The children with LCH were divided into nonpulmonary unifocal (n = 6), nonpulmonary multifocal (n = 6), and pulmonary (as indicated by x-ray film, clinical examination, or both) multifocal (n = 6) groups. Further BAL samples were taken from five children with pulmonary

Control group

CD1a-positive cells were present in 8 (13%) of 60 children with a mean value of 0.10% ± 0.07%. In seven cases, fewer than 1% of the cells were CD1a-positive. In the eighth case (sarcoidosis), 4% were CD1a-positive.

Pulmonary multifocal group

More than 5% of cells showed CD1a positivity in the six patients. The mean percentage was 30.6% ± 7.2% (range, 10% to 55%), significantly higher than in the nonpulmonary multifocal, nonpulmonary unifocal, and control groups (Fig. 1). Radiologic abnormalities were present on the chest

DISCUSSION

To our knowledge, this is the first pediatric study of CD1a-positive cells in BAL fluid. The percentage of CD1a-positive cell counts in BAL fluid varies from 1.8% to 25% in adults with PLCH and from 0% to 3.6% in control groups, including a small number of patients with sarcoidosis.4, 5, 6 Children with PLCH had much higher CD1a-positive cell counts (10% to 55%). This difference may reflect the intense activity of LCH in children: the younger the child, the poorer the prognosis. In children,

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From the Departments of Pneumologie et d'Allergologie Pédiatriques, Anatomopathologie, and Radiologie, Hôpital Necker-Enfants Malades, Paris, France

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Reprint requests: Luc Réfabert, MD, Service de Pneumologie et d'Allergologie Pédiatriques, Hôpital Necker-Enfants Malades, 149, rue de sevres, Paris, France.

0022-3476/96/$5.00 + 0 9/22/76361

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