Aetiology in adult patients with bronchiectasis

Shoemark, Amelia; Ozerovitch, Lorraine; Wilson, Robert

doi:10.1016/j.rmed.2006.11.008

Cited by 263 publications

(222 citation statements)

References 28 publications

(52 reference statements)

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“…Previous studies show that 26%-53% of cases of bronchiectasis have no known cause [65,66]. Chronic airway inflammation is supposed to be the primary cause of bronchiectasis, as observed in a condition that involves the airways, such as recurrent pulmonary infections, and autoimmune disease.…”

Section: Bronchiectasismentioning

confidence: 99%

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Yazdani

Abolhassani

et al. 2017

J Investig Allergol Clin Immunol

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Primary immunodeficiency disorders (PIDs) are caused by 1 or more defects of the immune system. Patients are more likely to experience recurrent and/or severe infections and tend to develop a wide range of complications. Respiratory diseases are the main and initial manifestation in most cases and the most common complication. Pulmonary complications cause significant morbidity and mortality in patients with PIDs. Early diagnosis and appropriate treatment can prevent or at least slow the development of respiratory complications. Since the spectrum of pulmonary complications in PIDs is broad, we divided pulmonary complications into upper respiratory complications (eg, sinusitis, otitis media, and laryngeal angioedema) and lower respiratory complications (eg, pneumonia, bronchitis, bronchiectasis, interstitial lung diseases, organizing pneumonia, pulmonary adenopathies and malignancies, hyperreactive airway diseases, pulmonary dysgenesis, and adverse reactions to treatment). This review covers the main respiratory manifestations in patients with PIDs. Key words: Primary immunodeficiency disorders. Pulmonary complications. Upper respiratory tract. Lower respiratory tract. ResumenLas inmunodeficiencias primarias (PIDs) son enfermedades causadas por uno o más defectos del sistema inmunológico. Estos pacientes presentan con frecuencia infecciones recidivantes y/o severas así como otro tipo de complicaciones. Las patologías respiratorias son la principal y más frecuente manifestación y complicación de las PIDs. Las complicaciones de estas patologías pulmonares constituyen una de las principales causas de morbimortalidad entre los pacientes que sufren PIDs. El diagnóstico temprano y el tratamiento adecuado pueden prevenir, o al menos retrasar, la aparición de las complicaciones respiratorias en estos pacientes. Dado que el espectro de las enfermedades pulmonares es muy amplio, hemos dividido estas complicaciones entre aquellas que afectan a las vías aéreas superiores (sinusitis, otitis media y angioedema laríngeo, etc.) y las que afectan a las vías aéreas bajas (neumonía, bronquitis, bronquiectasias, enfermedades pulmonares intersticiales, neumonía organizada, adenopatías pulmonares y neoplasias, hiperreactividad bronquial, disgenesia pulmonar y las debidas a los efectos secundarios del tratamiento instaurado). Este artículo revisa las manifestaciones respiratorias que se observan más frecuentemente en los pacientes con PIDs. Palabras clave: Inmunodeficiencias primarias. Complicaciones pulmonares. Vías respiratorias altas. Vías respiratorias bajas.

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Section: Bronchiectasismentioning

confidence: 99%

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Yazdani

Abolhassani

et al. 2017

J Investig Allergol Clin Immunol

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“…While idiopathic cases are most common, several risk factors and etiologies for the development of bronchiectasis were identified in previous studies on symptomatic bronchiectasis (Nicotra et al 1995;Pasteur et al 2000;Shoemark et al 2007): postinfectious complications, mucociliary clearance defects associated with genetic diseases, immune deficiency, and chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease. Of these, infectious diseases, including pulmonary TB, pertussis, measles, and nontuberculous Mycobacterial infection, were most frequently associated with the risk of developing bronchiectaisis.…”

Section: Respiratory Symptoms % (N)mentioning

confidence: 99%

High Prevalence of Bronchiectasis in Adults: Analysis of CT Findings in a Health Screening Program

Kwak

Moon

Choi

et al. 2010

Tohoku J. Exp. Med.

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Bronchiectasis is one of the common chronic respiratory diseases and associated with respiratory morbidity and mortality. However, neither its prevalence nor its etiology is well-defined. We aimed to estimate the prevalence and risk factors of bronchiectasis in adults. In a retrospective study, we analyzed radiologic findings on chest computed tomography (CT) images performed as part of a health-screening program. From January to December 2008, 1,409 (24.6%) of 5,727 participants in the screening program of a health promotion center at a university hospital underwent chest CT scans based on the subject' s decision. Bronchiectasis was diagnosed, if there was abnormal bronchial dilatation in any area of both lungs on chest CT. Respiratory symptoms, smoking status, and past medical history were also analyzed to define clinical characteristics and risk factors of bronchiectasis. Of 1,409 patients (aged 23-86 years), who were screened for respiratory diseases using chest CT for one year in a health promotion center, 129 patients (9.1%) were diagnosed with bronchiectasis. The prevalence of bronchiectasis was higher in females than in males (11.5% vs. 7.9%, p = 0.022) and increased with age. Respiratory symptoms were reported in 53.7% of subjects. Previous history of tuberculosis (TB) (OR 4.61, 95% CI 2.39-8.88, p = 0.001) and age (OR 2.49, 95% CI 1.56-3.98, p = 0.001) were significantly associated with bronchiectasis. This retrospective analysis of chest CT findings in health screening examinees revealed a very high prevalence of bronchiectasis in adults. Previous TB infection is one of the major causes of bronchiectasis.

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“…(12) Recent studies that attempted to determine the etiology of bronchiectasis in patients with cough, expectoration, and tomographic findings suggestive of bronchiectasis showed that the idiopathic form of the disease occurred in 26-53% of the patients. (13,14) Bronchiectasis caused by viral infections in childhood, humoral immunodeficiency, allergic bronchopulmonary aspergillosis, CF, and aspiration were the diseases most frequently diagnosed after the systematic analysis of these patients. The determination of the underlying disease requires considerable diagnostic effort and, in most cases, does not improve the prognosis or does not alter the clinical condition of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…The determination of the underlying disease requires considerable diagnostic effort and, in most cases, does not improve the prognosis or does not alter the clinical condition of the patients. According to one group of authors, (14) although the etiologic diagnosis was made in as many as 74% of the cases referred to a tertiary facility for the treatment of respiratory diseases, the treatment was changed in only 36% of the cases. However, the identification of allergic bronchopulmonary aspergillosis, rheumatoid arthritis, common variable immunodeficiency, aspiration pneumonia, and alpha-1 antitrypsin deficiency allows the initiation of specific treatment and behavioral counseling that can change the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Deve-se extrapolar o tratamento de bronquiectasias em pacientes com fibrose cística para aqueles com bronquiectasias de outras etiologias?

et al. 2010

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OBJETIVO: Conhecer o perfil de pacientes adultos com bronquiectasias, comparando portadores de fibrose cística (FC) com aqueles com bronquiectasias de outra etiologia, a fim de determinar se é racional extrapolar terapêuticas instituídas em fibrocísticos para aqueles com bronquiectasias de outras etiologias. MÉTODOS: Análise retrospectiva dos prontuários de 87 pacientes adultos com diagnóstico de bronquiectasia em acompanhamento em nosso serviço. Pacientes com doença secundária a infecção por tuberculose corrente ou no passado foram excluídos. Foram avaliados dados clínicos, funcionais e terapêuticos dos pacientes. RESULTADOS: Dos 87 pacientes com bronquiectasias, 38 (43,7%) tinham diagnóstico confirmado de FC através de dosagem de sódio e cloro no suor ou análise genética, enquanto 49 (56,3%) apresentavam a doença por outra etiologia, 34 (39,0%) desses com bronquiectasia idiopática. Os pacientes com FC apresentavam média de idade ao diagnóstico mais baixa (14,2 vs. 24,2 anos; p < 0,05). A prevalência de sintomas (tosse, expectoração, hemoptise e sibilância) foi semelhante entre os grupos. A colonização por Pseudomonas aeruginosa e a por Staphylococcus aureus foram mais comuns nos pacientes com FC (82,4 vs. 29,7% e 64,7 vs. 5,4%, respectivamente). CONCLUSÕES: As causas e as manifestações clínicas das bronquiectasias são heterogêneas, sendo importante a identificação dessas diferenças na abordagem do paciente. Reconhecer estas diferenças é crucial para o desenvolvimento de novas estratégias para o manejo de pacientes com bronquiectasias.

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Aetiology in adult patients with bronchiectasis

Abstract: Full investigation of problematic cases should occur in a specialist centre because results affect management in a third of cases.

Cited by 263 publications

References 28 publications

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

Infectious and Noninfectious Pulmonary Complications in Patients With Primary Immunodeficiency Disorders

High Prevalence of Bronchiectasis in Adults: Analysis of CT Findings in a Health Screening Program

Deve-se extrapolar o tratamento de bronquiectasias em pacientes com fibrose cística para aqueles com bronquiectasias de outras etiologias?

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