Bronchitis laboratory tests
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
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Bronchitis Main page |
Overview
Diagnostic tests are rarely needed to confirm the diagnosis of acute bronchitis. In very specific condition serologic tests, viral cultures or sputum analyses may be applied. Generally the inflammatory markers such as CRP raises during the course of acute bronchitis.
Chronic bronchitis is a diagnosis by definition although there are some laboratory findings as the disease advances and causes consequences.
Laboratory Findings
Acute Bronchitis
Viral cultures, serologic assays, and sputum analyses may be perform when a potentially treatable infection is thought to be circulating or because of epidemiologic purposes[1].
- Serologic assays
- Procalcitonin
Chronic Bronchitis
- Pulse Oximetry
- Though pulse oximetry is not as accurate in predicting the percentage oxygen saturation as arterial blood gas analysis. However, it gives a quick estimate of patient status when combined with the clinical status.
- Arterial Blood Gas (ABG)
- ABG may show changes of hypoxemia and hypercapnia depending on the severity of disease.
- Hematocrit
- COPD patients may have hypoxemia due to the chronic underlying disease. This chronic hypoxemia may lead to polycythemia(hematocrit > 55% in men or 50% in women is diagnostic of polycythemia.
- A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus spp.
- Alpha 1 Antitrypsin Levels[5]
- Serum alpha1 antitrypsin levels below the protective threshold value (ie, 3-7 mmol/L) lead to severe form of emphysema
- 95% cases are due to the severe variant the Z allele present in these patients.
- Specific phenotyping, and genetic counselling is reserved for patients in whom serum levels are 7-11 mmol/L.
References
- ↑ 1.0 1.1 Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
- ↑ Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, Neidert S, Fricker T, Blum C, Schild U, Regez K, Schoenenberger R, Henzen C, Bregenzer T, Hoess C, Krause M, Bucher HC, Zimmerli W, Mueller B (2009). "Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial". JAMA. 302 (10): 1059–66. doi:10.1001/jama.2009.1297. PMID 19738090.
- ↑ Briel M, Schuetz P, Mueller B, Young J, Schild U, Nusbaumer C, Périat P, Bucher HC, Christ-Crain M (2008). "Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care". Arch. Intern. Med. 168 (18): 2000–7, discussion 2007–8. doi:10.1001/archinte.168.18.2000. PMID 18852401.
- ↑ Gilbert DN (2011). "Procalcitonin as a biomarker in respiratory tract infection". Clin. Infect. Dis. 52 Suppl 4: S346–50. doi:10.1093/cid/cir050. PMID 21460294.
- ↑ "American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency". Am. J. Respir. Crit. Care Med. 168 (7): 818–900. 2003. doi:10.1164/rccm.168.7.818. PMID 14522813.