<div>The Effect of Therapeutic Bronchoalveolar Lavage in Combination with
Glucocorticoids on Children with Acute Exogenous Lipoid Pneumonia</div><div>Sen Yang<sup>1</sup>iD, Shangzhi Wu<sup>1</sup>, Jiaxing
Xu<sup>1</sup>,Yuneng Lin<sup>1</sup>, Zhanhang
Huang<sup>1</sup>, Xiaowen Chen<sup>1</sup>, Qingyun
Xu<sup>1</sup>, Dehui Chen<sup>1*</sup>, Chengyu
Lu<sup>1*</sup> iD</div><div>1.Department of Pediatrics, First Affiliated Hospital of Guangzhou
Medical University, Guangzhou 510120, Guangdong Province, China.</div><div>*correspondence author: Email: cdh84@126.com; fishlu1972@qq.com;</div><div>SY and SZ W equally contributed to this work and should be regarded as
first co-authors.</div><div><b>Background:</b> Exogenous lipoid pneumonia(ELP) is a rare disease
caused by the inhalation of oily materials in the alveoli with the
pathological characterization by the presence of laden-lipid macrophages
in the respiratory specimens. At present, the treatment norm for ELP has
not well defined, and so the aim of this study is to evaluate the effect
of bronchoalveolar lavage in combination with glucocorticoids on
children with ELP.</div><div><b>Methods and Materials:</b> We retrospectively reviewed 17 children
with a confirmed history of exogenous oily materials aspiration,
admitted to the First Affiliated Hospital of Guangzhou Medical
University from June 2012 to December 2021. Clinical features, blood
investigations, tomographic evaluations, therapeutic bronchoalveolar
lavage and glucocorticoids use were carried out at the beginning of
therapy and throughout a follow-up period.</div><div><b>Results:</b> The included children are the median age of 2 years.
Fever, dypnea and tachypnea were the most common symptoms. The most
common radiological features were airspace consolidations(15, 93.75%).
Chest CT scans showed areas of consolidation with air bronchogram(15,
93.75%), Poorly defined centrilobular nodules(13, 81.25%), areas of
ground-glass attenuation(11, 68.75%), and ‘crazy-paving’ pattern(6,
37.5%) in the both lower, right middle lung lobes. Neutrophil
percentage of peripheral blood and bronchoalveolar lavage fluid
exhibited a significantly higher than the normal range. After treatment
with multiple bronchoalveolar lavages and local administration of
budesonide during the hospital stay, taken by oral
prednisolone(1~2mg/kg) after discharge,all of children
became asymptomatic and presented normal radiological imagings in the
follow-up period.</div><div><b>Conclusion:</b> The most frequently findings in the CT scan of ELP
were consolidations and ground-glass attenuation in the both lower and
right middle lung lobes.Multiple bronchoalveolar lavages in combination
with oral prednisolone for children who had a confirmed history of
exogenous oily substances ingestion was an efficient and safe for the
clearance of oily materials from the lung and the prevention of
fibrosis. This strategy contributed to reducing the damage of ELP in
children patients.</div><div><b>Key Words:</b> Bronchoalveolar Lavage; Exogenous Lipoid Pneumonia;
Glucocorticoids Therapy; Children</div>