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(Chest. 2006;130:1626-1627.)
© 2006 American College of Chest Physicians

Clinical Applications of Induced Sputum

Christopher E. Brightling, PhD, FCCP

Glenfield Hospital, Leicester, UK

Correspondence to: Christopher Brightling, PhD, FCCP, Institute for Lung Health, University of Leicester, Glenfield Hospital, Groby Rd, Leicester LE3 9QP, UK; e-mail: ceb17{at}le.ac.uk

To the Editor:

I would like to thank Drs. Vinh and Menzies for their comments on the recent review in CHEST (May 2006)1 of the clinical applications of induced sputum testing.

The review was focused on the added value that sputum induction provides the clinician when managing patients with airways disease; in particular, that the presence of a sputum eosinophilia is important in the diagnosis of nonasthmatic chronic cough23 and is beneficial in guiding corticosteroid therapy in asthma patients.4 The value of sputum induction in the setting of other respiratory diseases such as the diagnosis of pulmonary tuberculosis (TB) and lung cancer, and its potential role in interstitial lung disease were highlighted but were given less prominence in the review.

Drs. Vinh and Menzies championed the role of induced sputum in the diagnosis of pulmonary TB. I agree that, compared to bronchoscopy, repeated induced sputum testing offers many advantages in terms of safety and cost with at least comparable if not greater diagnostic yield.5 Induced sputum testing in the diagnosis of pulmonary TB carries a risk of nosocomial TB; therefore, it is important to reiterate that it needs to be performed under conditions of respiratory isolation.

Therefore, induced sputum testing has a role in the management of several respiratory conditions and should be a technique that is widely available to respiratory physicians.

Footnotes

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

References

  1. Brightling, CE (2006) Clinical applications of induced sputum. Chest 129,1344-1348[Abstract/Free Full Text]
  2. Brightling, CE Chronic cough due to nonasthmatic eosinophilic bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006;129(suppl),116S-121S[Abstract/Free Full Text]
  3. Melvin, R, Pratter, MR, Brightling, CE, et al An empiric integrative approach to the management of cough: ACCP evidence-based clinical practice guidelines. Chest 2006;129(suppl),222S-231S[Abstract/Free Full Text]
  4. Green, RH, Brightling, CE, McKenna, S, et al Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial. Lancet 2002;360,1715-1721[CrossRef][ISI][Medline]
  5. McWilliams, T, Wells, AU, Harrison, AC, et al Induced sputum and bronchoscopy in the diagnosis of pulmonary tuberculosis. Thorax 2002;57,1010-1014[Abstract/Free Full Text]




This Article
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