Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis
Olivia Sánchez-Cabral,1 Dina Martínez-Mendoza,1,2 Ángel Paul Flores-Bello,3 José Arturo Martínez-Orozco,4 Rosa María Rivera-Rosales,5 César Luna-Rivero,5 Patricio Santillán-Doherty,6 Gustavo Reyes-Terá...
Guardado en:
| Autores principales: | , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Dove Medical Press
2018
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/2aa22e04b4df46a5a938cfa12eb5ce54 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:2aa22e04b4df46a5a938cfa12eb5ce54 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:2aa22e04b4df46a5a938cfa12eb5ce542021-12-02T06:13:09ZDiagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis1179-1373https://doaj.org/article/2aa22e04b4df46a5a938cfa12eb5ce542018-07-01T00:00:00Zhttps://www.dovepress.com/diagnostic-discrepancy-between-bronchoalveolar-lavage-and-transbronchi-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Olivia Sánchez-Cabral,1 Dina Martínez-Mendoza,1,2 Ángel Paul Flores-Bello,3 José Arturo Martínez-Orozco,4 Rosa María Rivera-Rosales,5 César Luna-Rivero,5 Patricio Santillán-Doherty,6 Gustavo Reyes-Terán7 1Interventional Pulmonology Unit, 2Hospital Epidemiology Surveillance Unit, 3Clinic of Tuberculosis and Pleural Diseases, 4Department of Infectious Diseases and Clinical Microbiology, 5Anatomic Pathology Service, 6Medical Direction, 7Department of Research in Infectious Diseases, National Institute of Respiratory Diseases Ismael Cosío Villegas, Mexico City, Mexico Background: The key diagnostic method for the evaluation of lung diseases associated with HIV infection is bronchoscopy, with bronchoalveolar lavage (BAL) being the most commonly used sampling technique. Transbronchial biopsy (TBB) is often complementary. Setting: This is a retrospective cross-sectional study to determine the diagnostic usefulness of bronchoscopy with simultaneous samples obtained through BAL and TBB in HIV-infected patients with pneumonia at the National Institute of Respiratory Diseases Ismael Cosío Villegas. Methods: In this cross-sectional study (January 2014–December 2015), the diagnostic yield of bronchoscopic samples from all HIV-positive patients with pneumonia aged >18 years, from procedures performed in the Interventional Pulmonology Unit, was analyzed and recorded in its database. The diagnostic yield concordance between BAL and TBB samples was evaluated by kappa index calculation. Results: A total of 198 procedures on 189 HIV-infected patients with pneumonia were performed. A total of 167/189 (88.4%) patients were male, and the mean age was 34.7 years (SD ±9.0). Overall, the diagnostic yield for either technique was 87.9% (174/198), but it was higher for TBB, its yield being 78.8% (156/198). In contrast, that of BAL was 62.1% (123/198) (P=0.001). The overall diagnostic yield concordance between TBB and BAL was insignificant (κ=0.213, P<0.001). It improved for fungal infections, pneumocystosis, and tuberculosis (κ=0.417, 0.583, and 0.462, respectively, all P<0.001). Conclusion: Our results show that the simultaneous obtainment of BAL and TBB samples is useful and complementary in the diagnosis of infections and malignancies in HIV-infected patients. Additionally, they are safe procedures in this group of patients. Keywords: bronchoalveolar lavage, transbronchial biopsy, HIV, BAL, TBB, interventional bronchoscopy, bronchoscopySánchez-Cabral OMartínez-Mendoza DFlores-Bello ÁPMartínez-Orozco JARivera-Rosales RMLuna-Rivero CSantillán-Doherty PReyes-Terán GDove Medical Pressarticlebronchoalveolar lavagetransbronchial biopsyHIVInterventional bronchoscopyBronchoscopy.Immunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 10, Pp 115-123 (2018) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
bronchoalveolar lavage transbronchial biopsy HIV Interventional bronchoscopy Bronchoscopy. Immunologic diseases. Allergy RC581-607 |
| spellingShingle |
bronchoalveolar lavage transbronchial biopsy HIV Interventional bronchoscopy Bronchoscopy. Immunologic diseases. Allergy RC581-607 Sánchez-Cabral O Martínez-Mendoza D Flores-Bello ÁP Martínez-Orozco JA Rivera-Rosales RM Luna-Rivero C Santillán-Doherty P Reyes-Terán G Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| description |
Olivia Sánchez-Cabral,1 Dina Martínez-Mendoza,1,2 Ángel Paul Flores-Bello,3 José Arturo Martínez-Orozco,4 Rosa María Rivera-Rosales,5 César Luna-Rivero,5 Patricio Santillán-Doherty,6 Gustavo Reyes-Terán7 1Interventional Pulmonology Unit, 2Hospital Epidemiology Surveillance Unit, 3Clinic of Tuberculosis and Pleural Diseases, 4Department of Infectious Diseases and Clinical Microbiology, 5Anatomic Pathology Service, 6Medical Direction, 7Department of Research in Infectious Diseases, National Institute of Respiratory Diseases Ismael Cosío Villegas, Mexico City, Mexico Background: The key diagnostic method for the evaluation of lung diseases associated with HIV infection is bronchoscopy, with bronchoalveolar lavage (BAL) being the most commonly used sampling technique. Transbronchial biopsy (TBB) is often complementary. Setting: This is a retrospective cross-sectional study to determine the diagnostic usefulness of bronchoscopy with simultaneous samples obtained through BAL and TBB in HIV-infected patients with pneumonia at the National Institute of Respiratory Diseases Ismael Cosío Villegas. Methods: In this cross-sectional study (January 2014–December 2015), the diagnostic yield of bronchoscopic samples from all HIV-positive patients with pneumonia aged >18 years, from procedures performed in the Interventional Pulmonology Unit, was analyzed and recorded in its database. The diagnostic yield concordance between BAL and TBB samples was evaluated by kappa index calculation. Results: A total of 198 procedures on 189 HIV-infected patients with pneumonia were performed. A total of 167/189 (88.4%) patients were male, and the mean age was 34.7 years (SD ±9.0). Overall, the diagnostic yield for either technique was 87.9% (174/198), but it was higher for TBB, its yield being 78.8% (156/198). In contrast, that of BAL was 62.1% (123/198) (P=0.001). The overall diagnostic yield concordance between TBB and BAL was insignificant (κ=0.213, P<0.001). It improved for fungal infections, pneumocystosis, and tuberculosis (κ=0.417, 0.583, and 0.462, respectively, all P<0.001). Conclusion: Our results show that the simultaneous obtainment of BAL and TBB samples is useful and complementary in the diagnosis of infections and malignancies in HIV-infected patients. Additionally, they are safe procedures in this group of patients. Keywords: bronchoalveolar lavage, transbronchial biopsy, HIV, BAL, TBB, interventional bronchoscopy, bronchoscopy |
| format |
article |
| author |
Sánchez-Cabral O Martínez-Mendoza D Flores-Bello ÁP Martínez-Orozco JA Rivera-Rosales RM Luna-Rivero C Santillán-Doherty P Reyes-Terán G |
| author_facet |
Sánchez-Cabral O Martínez-Mendoza D Flores-Bello ÁP Martínez-Orozco JA Rivera-Rosales RM Luna-Rivero C Santillán-Doherty P Reyes-Terán G |
| author_sort |
Sánchez-Cabral O |
| title |
Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| title_short |
Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| title_full |
Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| title_fullStr |
Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| title_full_unstemmed |
Diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of HIV patients with pneumonia: toward an integral diagnosis |
| title_sort |
diagnostic discrepancy between bronchoalveolar lavage and transbronchial biopsy from bronchoscopies of hiv patients with pneumonia: toward an integral diagnosis |
| publisher |
Dove Medical Press |
| publishDate |
2018 |
| url |
https://doaj.org/article/2aa22e04b4df46a5a938cfa12eb5ce54 |
| work_keys_str_mv |
AT sanchezcabralo diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT martinezmendozad diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT floresbelloap diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT martinezorozcoja diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT riverarosalesrm diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT lunariveroc diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT santillandohertyp diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis AT reyesterang diagnosticdiscrepancybetweenbronchoalveolarlavageandtransbronchialbiopsyfrombronchoscopiesofhivpatientswithpneumoniatowardanintegraldiagnosis |
| _version_ |
1718399981038075904 |