Recurrent aspiration in children: Lipid‐laden alveolar macrophage quantitation

We prospectively evaluated bronchial washings from 45 patients aged 1 month to 25 years (mean 3.3 years) for the presence of lipid‐laden macrophages. By grading the amount of intracellular oil‐red‐O‐positive material, we determined a semiquantitative lipid‐laden macrophage index for each patient. All patients observed to be definite aspirators (n = 22) had indexes ≥86 (mean ± SD, 139 ± 46). All patients with no clinical suspicion of aspiration (n = 23) had indexes ⩽72 (mean ± SD, 21 ± 20). Our results suggest that simply sighting lipid‐laden macrophages is a nonspecific finding, but quantitation of these cells may be a very good test for recurrent aspiration of food substances in children. This test appears to be more sensitive than radiographic studies. Pediatr Pulmonol 1987; 3:89–89.