Chronic aspiration in children: Evaluation of the lipid-laden macrophage index

Chronic pulmonary aspiration (CPA) causes significant morbidity, but is underdiagnosed because of difficulties in establishing a diagnosis. The lipid‐laden macrophage index (LLMI) is said to differentiate between those with and without CPA. Records of 113 patients were reviewed to determine specificity and sensitivity of the LLMI for CPA. Diagnostic accuracy was inferred from treatment outcome. Mean LLMI for aspirators was 104 ± 62 (range, 20–233), and for nonaspirators, 44 ± 39 (range, 0–170) (P < 0.05). Sensitivity and specificity were 0.69 and 0.79, respectively. While the LLMI provides clinically helpful information, it does not stand alone as the gold standard for the diagnosis of CPA. Failure to thrive and neurological impairment correlated with CPA, using Fisher's exact test. CPA was not diagnosed in any patient with normal growth, normal neurological development, and an LLMI