Persistent asthma in adults: comparison of high resolution computed tomography of the lungs after one year of follow-up

Cukier, Alberto; Stelmach, Rafaël; Kavakama, Jorge; Filho, Mário Terra; Vargas, Francisco S.

doi:10.1590/s0041-87812001000300001

Cited by 13 publications

(12 citation statements)

References 25 publications

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“…Bronchiectasis is generally defined as an irreversible widening of the airway. The reversibility of radiological bronchiectasis has been discussed in a number of case reports [42,43], and in a few small retrospective studies including both adult and paediatric patients [44][45][46][47]. A few critical notes are needed.…”

Section: Reversibility Of Bronchiectasismentioning

confidence: 99%

“…When sequential CT protocols are used, this is not usually possible and smaller bronchiectasis visible on the baseline scan can therefore be easily missed on the follow-up scan. This is especially relevant for older studies reporting reversibility of bronchiectasis when sequential protocols were more likely to be used [45,47]. Differences in slice thickness and/or image reconstruction kernels between the baseline CT scan and follow-up scan can also result in "disappearance" of a bronchiectasis airway.…”

Section: Reversibility Of Bronchiectasismentioning

confidence: 99%

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The radiological diagnosis of bronchiectasis: what's in a name?

et al. 2020

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Diagnosis of bronchiectasis is usually made using chest computed tomography (CT) scan, the current gold standard method. A bronchiectatic airway can show abnormal widening and thickening of its airway wall. In addition, it can show an irregular wall and lack of tapering, and/or can be visible in the periphery of the lung. Its diagnosis is still largely expert based. More recently, it has become clear that airway dimensions on CT and therefore the diagnosis of bronchiectasis are highly dependent on lung volume. Hence, control of lung volume is required during CT acquisition to standardise the evaluation of airways. Automated image analysis systems are in development for the objective analysis of airway dimensions and for the diagnosis of bronchiectasis. To use these systems, clear and objective definitions for the diagnosis of bronchiectasis are needed. Furthermore, the use of these systems requires standardisation of CT protocols and of lung volume during chest CT acquisition. In addition, sex- and age-specific reference values are needed for image analysis outcome parameters. This review focusses on today's issues relating to the radiological diagnosis of bronchiectasis using state-of-the-art CT imaging techniques.

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Section: Reversibility Of Bronchiectasismentioning

confidence: 99%

Section: Reversibility Of Bronchiectasismentioning

confidence: 99%

The radiological diagnosis of bronchiectasis: what's in a name?

et al. 2020

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“…Bronchiectasis can be identified before the definitive diagnosis of asthma [73] or during the disease course, with a wide frequency ranging from 0.8 to 77% [7][8][9][10][11][12][13][14][15][16][17][18][19][20] (17.5-40% [10,15,74] in mild forms and 67.5-77% [7,18] in severe forms [ Table 2]). This wide variability is caused by the different analytical methods used in each study: type of enrolled patient populations, sample size, diagnostic criteria for the detection of bronchiectasis (e.g., the CT scan is often operator dependent), and not known causes of diagnosed bronchiectasis.…”

Section: Prevalence Of Bronchiectasis In Asthmamentioning

confidence: 99%

The Link between Asthma and Bronchiectasis: State of the Art

et al. 2020

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The nonrecognition of asthma-associated comorbidities is often responsible for the therapeutic failure and the worsening of symptoms, and it is associated with frequent exacerbations, higher disease severity, and increased health costs. Bronchiectasis, one of the most frequent asthma-associated comorbidities, can increase airways inflammation and exacerbation rates and cause respiratory functional impairment. The aim of this article is to review the interactions between bronchiectasis and asthma, in order to better identify patients in the overlap between the 2 diseases and to select an "ad hoc" therapy. A literature search on PubMed/MEDLINE was performed using the following search terms: bronchiectasis in asthma, the association between asthma and bronchiectasis, comorbidities in asthma, and severe asthma. This review analyzed the following items: incorrect or underestimated diagnosis of asthma and bronchiectasis, prevalence of bronchiectasis in asthma, the impact of bronchiectasis in asthma, radiological imaging features of the 2 diseases, etiopathogenesis, and common causes (such as gastroesopha-geal reflux disease, immune deficits, chronic rhinosinusitis and allergic bronchopulmonary aspergillosis, and treatment of asthma and bronchiectasis). The concomitant presence of bronchiectasis and asthma should be suspected and investigated in patients with severe asthma, frequent exacerbations, and not responding to standard therapy. This clinical phenotype, characterized by a more severe disease, worse outcomes, and functional decline, must be readily recognized in order to choose the most appropriate therapeutic approach, able to potentially improve the management of bronchial asthma, to prevent the onset of exacerbations as well the functional decline, and to reduce health costs.

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“…On the other hand, despite the improvements in the control of pulmonary infectious diseases, the incidence of bronchiectasis does not seem to be declining—perhaps because the widespread use of high-resolution chest tomography (HRCT) has allowed easy diagnosis of its clinically silent minor forms. The use of CT to diagnose bronchiectasis has been validated in various studies [10]. Overall, today, the etiology is identified in fewer than 50% of patients with the condition [4, 11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Bronchiectasis in Asthma according to Oral Steroid Requirement: Influence of Immunoglobulin Levels

Luján

Gallardo

Amengual

et al. 2013

BioMed Research International

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Purpose. To establish the prevalence of bronchiectasis in asthma in relation to patients' oral corticosteroid requirements and to explore whether the increased risk is due to blood immunoglobulin (Ig) concentration. Methods. Case-control cross-sectional study, including 100 sex- and age-matched patients, 50 with non-steroid-dependent asthma (NSDA) and 50 with steroid-dependent asthma (SDA). Study protocol: (a) measurement of Ig and gG subclass concentration; (b) forced spirometry; and (c) high-resolution thoracic computed tomography. When bronchiectasis was detected, a specific etiological protocol was applied to establish its etiology. Results. The overall prevalence of bronchiectasis was 12/50 in the SDA group and 6/50 in the NSDA group (p = ns). The etiology was documented in six patients (four NSDA and two SDA). After excluding these patients, the prevalence of bronchiectasis was 20% (10/50) in the SDA group and 2/50 (4%) in the NSDA group (P < 0.05). Patients with asthma-associated bronchiectasis presented lower FEV1 values than patients without bronchiectasis, but the levels of Ig and subclasses of IgG did not present differences. Conclusions. Steroid-dependent asthma seems to be associated with a greater risk of developing bronchiectasis than non-steroid-dependent asthma. This is probably due to the disease itself rather than to other influencing factors such as immunoglobulin levels.

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Persistent asthma in adults: comparison of high resolution computed tomography of the lungs after one year of follow-up

Cited by 13 publications

References 25 publications

The radiological diagnosis of bronchiectasis: what's in a name?

The radiological diagnosis of bronchiectasis: what's in a name?

The Link between Asthma and Bronchiectasis: State of the Art

Prevalence of Bronchiectasis in Asthma according to Oral Steroid Requirement: Influence of Immunoglobulin Levels

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