Bronchiolitis laboratory tests: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnosis of bronchiolitis is mainly clinical, because the laboratory diagnosis is not specific for the [[disease]]. Commonly used laboratory tests include [[Viral pathogenesis|viral pathogen tests]] for example, [[Enzyme linked immunosorbent assay (ELISA)|ELISA]], [[Immunofluorescence|immunofluorescent]] assays, and optical [[immunoassays]]. [[Complete blood count]] is also not specific for [[bronchiolitis]]. [[Pulmonary function tests]] may be helpful in supporting the diagnosis and excluding other [[Chronic obstructive pulmonary disease|obstructive lung diseases]]. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Evidence has not shown laboratory tests to be beneficial in the diagnosis of bronchiolitis or the assessment of severity. Diagnosis of bronchiolitis and of the severe forms of the disease should be made based on clinical findings and risk factors. | Evidence has not shown laboratory tests to be beneficial in the diagnosis of bronchiolitis or the assessment of severity. Diagnosis of bronchiolitis and of the severe forms of the disease should be made based on clinical findings and risk factors. | ||
*Specific viral testing has not shown benefits, as there will not be any changes in the management or the prognosis of the disease if the specific pathogen is determined. However, some institutions use specific RSV tests to prevent nosocomial spread of the disease.<ref name="pmid14757603">{{cite journal| author=Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L et al.| title=Diagnosis and testing in bronchiolitis: a systematic review. | journal=Arch Pediatr Adolesc Med | year= 2004 | volume= 158 | issue= 2 | pages= 119-26 | pmid=14757603 | doi=10.1001/archpedi.158.2.119 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14757603 }} </ref> | *Specific viral testing has not shown benefits, as there will not be any changes in the management or the [[prognosis]] of the disease if the specific [[pathogen]] is determined. However, some institutions use specific [[Human respiratory syncytial virus|RSV]] tests to prevent nosocomial spread of the disease.<ref name="pmid14757603">{{cite journal| author=Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L et al.| title=Diagnosis and testing in bronchiolitis: a systematic review. | journal=Arch Pediatr Adolesc Med | year= 2004 | volume= 158 | issue= 2 | pages= 119-26 | pmid=14757603 | doi=10.1001/archpedi.158.2.119 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14757603 }} </ref> | ||
*Specific viral pathogen tests are available. Specific [[antigen]] based tests are more commonly used:<ref name="Mendell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref> | *Specific [[viral]] [[pathogen]] tests are available. Specific [[antigen]] based tests are more commonly used:<ref name="Mendell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref> | ||
**[[ELISA]] | **[[ELISA]] | ||
**Direct [[immunofluorescent]] assays | **Direct [[immunofluorescent]] assays | ||
| Line 23: | Line 23: | ||
*The [[complete blood counts]] (CBC) vary between each patient and have not shown benefits for the diagnosis of bronchiolitis.<ref name="Mendell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref> | *The [[complete blood counts]] (CBC) vary between each patient and have not shown benefits for the diagnosis of bronchiolitis.<ref name="Mendell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref> | ||
*[[Pulmonary function tests]] are used to confirm the diagnosis of bronchiolitis and to exclude other [[pulmonary]] abnormalities. They show irreversible obstructive lung changes and | *[[Pulmonary function tests]] are used to confirm the [[diagnosis]] of bronchiolitis and to exclude other [[pulmonary]] abnormalities. They show irreversible [[Obstructive lung disease|obstructive lung changes]] and increased [[residual volume]] and [[functional residual capacity]].<ref name="pmid18339530">{{cite journal| author=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM et al.| title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients. | journal=Respir Med | year= 2008 | volume= 102 | issue= 6 | pages= 825-30 | pmid=18339530 | doi=10.1016/j.rmed.2008.01.016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18339530 }} </ref> | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]
Overview
The diagnosis of bronchiolitis is mainly clinical, because the laboratory diagnosis is not specific for the disease. Commonly used laboratory tests include viral pathogen tests for example, ELISA, immunofluorescent assays, and optical immunoassays. Complete blood count is also not specific for bronchiolitis. Pulmonary function tests may be helpful in supporting the diagnosis and excluding other obstructive lung diseases.
Laboratory Findings
Evidence has not shown laboratory tests to be beneficial in the diagnosis of bronchiolitis or the assessment of severity. Diagnosis of bronchiolitis and of the severe forms of the disease should be made based on clinical findings and risk factors.
- Specific viral testing has not shown benefits, as there will not be any changes in the management or the prognosis of the disease if the specific pathogen is determined. However, some institutions use specific RSV tests to prevent nosocomial spread of the disease.[1]
- Specific viral pathogen tests are available. Specific antigen based tests are more commonly used:[2]
- ELISA
- Direct immunofluorescent assays
- Indirect immunofluorescent assays
- Optical immunoassays
- Tests are available for the following viruses:
- The complete blood counts (CBC) vary between each patient and have not shown benefits for the diagnosis of bronchiolitis.[2]
- Pulmonary function tests are used to confirm the diagnosis of bronchiolitis and to exclude other pulmonary abnormalities. They show irreversible obstructive lung changes and increased residual volume and functional residual capacity.[3]
References
- ↑ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L; et al. (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
- ↑ 2.0 2.1 Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier.
- ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM; et al. (2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.