Bronchiolitis laboratory tests

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.

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]

↑ 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.