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Higher nasopharyngeal LDH levels linked to less severe bronchiolitis
Children with higher nasopharyngeal lactate dehydrogenase levels tended to have less severe bronchiolitis than children with lower levels, according to study results.
Jonathan M. Mansbach, MD, of the Children’s Hospital of Boston, and colleagues tested 258 samples for nasopharyngeal lactate dehydrogenase (LDH) levels from children aged younger than 2 years who had been diagnosed with bronchiolitis in the ED.
The researchers, including Infectious Diseases in Children Editorial Board member Pedro A. Piedra, MD, reported that nasopharyngeal aspirate (NPA) contained a median of 6.7 U/mL LDH. Of the 258 samples tested, 62% were positive for respiratory syncytial virus (RSV), 16% for human rhinovirus (HRV), 10% for metapneumovirus and 7% for influenza A. No child tested positive for influenza B. Samples testing positive for RSV were found to have higher levels of LDH; samples with HRV bronchiolitis also had higher levels of LDH, according to the data.
“When examining both RSV and HRV together, children with HRV only or HRV and RSV coinfection had higher LDH than children with RSV only or neither virus,” the researchers wrote, adding that the children with low levels of LDH were more likely to be hospitalized with severe bronchiolitis than children with higher levels.
Mansbach and colleagues said use of NPA was “novel” because LDH samples are usually obtained from pulmonary fluid and bronchoalveolar lavage fluid assessment. However, “based on the results of the recent single-center study by Laham and colleagues and our multicenter data, nasopharyngeal LDH has potential utility as a marker of bronchiolitis severity. Ideally, this marker would assist clinicians, especially those working in the ED, when the disposition decision is unclear.”
Disclosure: Dr. Mansbach reports no relevant financial disclosures.
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