The significance of fat‐filled macrophages in the diagnosis of aspiration associated with gastro‐oesophageal reflux

ABSTRACTTracheal aspirates from 46 children were examined for the presence of fat‐filled macrophages. They had no history suggestive of gastro‐oesophageal reflux. The number of positive results from this group (46%) was compared with the number of positive results (73%) in a group of 40 children with proven gastro‐oesophageal reflux. The difference in proportion of positive results between the two groups was statistically significant (P<0.05). In addition, subgroups of subjects, negative for gastro‐oesophageal reflux and lower respiratory tract disease, were compared with children who had both conditions. A slightly greater difference, although at a similar level of significance, was found. The fact that 42% of subjects without lower respiratory tract disease or gastro‐oesophageal reflux had tracheal aspirates positive for fat‐filled macrophages would, however, suggest that this test is of limited clinical value and may need better quantitation before it can be recommended for widespread clinical use.