Abstract
Lung parenchymal and airway changes on CT imaging following allergen challenge and bronchoalveolar lavage in atopic and asthmatic subjects
Annals of translational medicine, Vol.8(14), pp.862-862
07/01/2020
DOI: 10.21037/atm-20-1719
PMCID: PMC7396741
PMID: 32793706
Abstract
Background: Computed tomography (CT) imaging findings in the lungs in the setting of an acute allergic response and following bronchoalveolar lavage (BAL) are not well established. Our goals are to characterize the pulmonary CT findings of acute allergic response in both asthmatic and non-asthmatic subjects and, secondarily, to characterize the pulmonary imaging findings following BAL.
Methods: In this prospective observational (cohort) study, we identified atopic, asthmatic (AA) and atopic, non-asthmatic (ANA) subjects. CT of the chest was performed following BAL and instillation of an allergen (AL) and of an inert diluent (DL). Two radiologists analyzed the CT examinations for airway and parenchymal changes.
Results: We had a cohort of 20 atopic subjects (AA=10, ANA=10; F=11, M=9; median age: 23.5 years, range: 18-48 years). Compared to diluent instillation and BAL, allergen instillation resulted in more significant bronchial wall thickening (AL=70%, DL=0%, BAL=0%, P<0.01), consolidations (AL=55%, DL=0%, BAL=15%, P<0.05), and septal thickening (AL=35%, DL=0%, BAL=0%, P<0.01). When present, consolidations tended to be more common in asthmatic subjects compared to non-asthmatics following instillation of the allergen, although this did not reach statistical significance (AA=80% vs. ANA=30%; P=0.07). BAL, on the other hand, resulted in more ground-glass opacities (BAL=15/20, 75% vs. AL=2/20, 10%, vs. DL=0/20, 0%; P<0.01).
Conclusions: Acute allergic response in the lungs can result in significant bronchial wall thickening, septal thickening, and consolidations in those with atopy, particularly those with asthma. Localized groundglass opacities may be expected following BAL, and care should be taken so as to not misinterpret these as significant pathology.
Details
- Title: Subtitle
- Lung parenchymal and airway changes on CT imaging following allergen challenge and bronchoalveolar lavage in atopic and asthmatic subjects
- Creators
- Dexter P. Mendoza - Massachusetts General HospitalPuja Kohli - Massachusetts General HospitalJohn W. Nance - Massachusetts General HospitalRamandeep Singh - Massachusetts General HospitalJosalyn Cho - Massachusetts General HospitalJason Griffith - Massachusetts General HospitalR. Scott Harris - Massachusetts General HospitalVanessa J. Kelly - Massachusetts General HospitalAndrew D. Luster - Massachusetts General HospitalBenjamin Medoff - Massachusetts General HospitalSubba R. Digumarthy - Massachusetts General Hospital
- Resource Type
- Abstract
- Publication Details
- Annals of translational medicine, Vol.8(14), pp.862-862
- DOI
- 10.21037/atm-20-1719
- PMID
- 32793706
- PMCID
- PMC7396741
- NLM abbreviation
- Ann Transl Med
- ISSN
- 2305-5839
- eISSN
- 2305-5839
- Publisher
- Ame Publ Co
- Number of pages
- 9
- Grant note
- U19AI095261; R37AI040618; T32HL116275 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Radiology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984361562502771
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