Wang WY, Wan SH, Zheng YL, Zhou LM, Zhang H, Jiang LB. Value of eosinophil count in bronchoalveolar lavage fluid for diagnosis of allergic bronchopulmonary aspergillosis: A case report. World J Clin Cases 2021; 9(27): 8142-8146 [PMID: 34621873 DOI: 10.12998/wjcc.v9.i27.8142]
Corresponding Author of This Article
Li-Bin Jiang, MD, Chief Doctor, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. jkzjuedu@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wei-Yi Wang, Hong Zhang, Li-Bin Jiang, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Shan-Hong Wan, Ling-Ming Zhou, Department of Respiratory Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Yu-Lu Zheng, Department of Respiratory Medicine, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
Author contributions: Jiang LB and Wang WY performed the postoperative evaluation and diagnosis; Wang WY and Wan SH reviewed the literature and contributed to manuscript drafting; Wan SH, Zheng YL, Zhou LM, and Zhang H collected the medical data; all authors issued final approval for the submitted version.
Supported byZhejiang Provincial Department of Education, No. Y202045102.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Bin Jiang, MD, Chief Doctor, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. jkzjuedu@163.com
Received: April 10, 2021 Peer-review started: April 10, 2021 First decision: July 5, 2021 Revised: July 15, 2021 Accepted: August 13, 2021 Article in press: August 13, 2021 Published online: September 26, 2021 Processing time: 158 Days and 18.1 Hours
Abstract
BACKGROUND
An immediate hypersensitive immune response to Aspergillus fumigatus antigens is one of the main characteristic features of allergic bronchopulmonary aspergillosis (ABPA). As ABPA is an allergic respiratory disease, immunoglobulin E and peripheral-blood eosinophilia have been used as diagnostic indicators. However, eosinophilia in bronchoalveolar lavage fluid (BALF) has not been considered in the diagnostic criteria for ABPA.
CASE SUMMARY
We present a case of ABPA in which the eosinophil count in peripheral blood was not increased, whereas the eosinophil percentage in BALF reached 60%. After antifungal and hormone therapy, imaging revealed very good resolution of lung infiltration.
CONCLUSION
The value of the eosinophil count in BALF for the diagnosis of ABPA is worthy of the clinician's attention, especially when the patient’s clinical features lack specificity and the diagnostic parameters are negative.
Core Tip: Peripheral blood eosinophilia rather than eosinophilia in bronchoalveolar lavage fluid (BALF) has been used as a diagnostic indicator for allergic bronchopulmonary aspergillosis (ABPA). However, in our case, the eosinophil count in peripheral blood was not increased, whereas the eosinophil percentage in BALF reached 60%. We present this case report to explain the value of the eosinophil count in BALF for the diagnosis of ABPA.
