Abstract:Rationale: Testing for underlying etiology is a key part of bronchiectasis management, but it is unclear whether the same extent of testing is required across the spectrum of disease severity.Objectives: The aim of the present study was to identify the etiology of bronchiectasis across European cohorts and according to different levels of disease severity.
Methods:We conducted an analysis of seven databases of adult outpatients with bronchiectasis prospectively enrolled at the bronchiectasis clinics of univers… Show more
“…Bronchiectasis was diagnosed by chest radiography in 5% and by bronchography in 1% of the rest of the population, while 1% had a clinical diagnosis alone. The second statement recommends that patients should be investigated for allergic bronchopulmonary aspergillosis (ABPA), common variable immunodeficiency (CVID) and cystic fibrosis (CF), the last of these if indicated, as these are specific and treatable causes of bronchiectasis [11]. In the SIP audit, only 435 (32%) patients were tested for at least one of the above: 17% of the patients had been investigated for ABPA, 22% for CVID and 5.5% for CF.…”
“…Bronchiectasis was diagnosed by chest radiography in 5% and by bronchography in 1% of the rest of the population, while 1% had a clinical diagnosis alone. The second statement recommends that patients should be investigated for allergic bronchopulmonary aspergillosis (ABPA), common variable immunodeficiency (CVID) and cystic fibrosis (CF), the last of these if indicated, as these are specific and treatable causes of bronchiectasis [11]. In the SIP audit, only 435 (32%) patients were tested for at least one of the above: 17% of the patients had been investigated for ABPA, 22% for CVID and 5.5% for CF.…”
“…4 In comparison, this was only slightly more frequent than bronchiectasis related to ciliary dysfunction and approximately a third of the cases due to immunodeficiency. Interestingly, while bronchiectasis is usually associated with active IBD, it has also been reported to develop after colectomy.…”
Section: Large Airway Involvementmentioning
confidence: 94%
“…Pathologists must therefore remember that in the normal small bronchioles, the epithelial layer is generally in close proximity to the underlying muscular layer, and that any increase in the subepithelial fibrous tissue compartment is abnormal. Since the degree of airway resistance is related to 1/radius, 4 even a tiny degree of narrowing will have a significant effect on pulmonary function. In comparison, when the airway is completely obliterated, an elastic stain may be necessary to show that an area of fibrosis adjacent to a pulmonary artery is actually an airway remnant ( Figure 4, A and B).…”
Although airway disease associated with inflammatory bowel disease is uncommon, its involvement may have severe clinical consequences. This article reviews the breadth of pathologic processes that can be expected in the various sizes of airways, and provides a differential diagnosis from other airway diseases that can be found in association with inflammatory bowel disease. It also makes suggestions as to how airway disease can be best differentiated by using appropriate special stains.
“…Despite identification of these key features on CT and extensive testing, no underlying aetiology is found in a large proportion of patients with bronchiectasis 46. The prevalence of idiopathic bronchiectasis varies amongst cohorts (32%‐66%) likely owing to geographic variations, diagnostic algorithms and other determinants 30, 47, 48, 49, 50, 51…”
SummaryAimsNon‐cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT).MethodsFor this review, trials and reports were identified from PubMed/Medline and ClinicalTrials.gov from the US NIH and the Cochrane Register of Controlled Trials. The search used keywords: bronchiectasis, non‐cystic fibrosis bronchiectasis, chronic pulmonary infection and computed tomography. No date/language restrictions were used.ResultsNon‐cystic fibrosis bronchiectasis often coexists with other respiratory conditions, such as chronic obstructive pulmonary disease. The prevalence of NCFB is increasing, particularly in women and older individuals, possibly as a result of increased physician awareness and widespread use of CT, which is the gold standard for the diagnosis of NCFB. CT can assist in identifying an underlying cause of NCFB and determining the extent and severity of the disease.DiscussionNon‐cystic fibrosis bronchiectasis should be suspected in the primary care setting in patients with chronic cough, purulent sputum and frequent respiratory infections that tend to resolve slowly or partially. Early diagnosis and determination of the extent and severity of the disease by CT and other tests are critical to establish therapy to improve quality of life and potentially slow progressive decline of lung function in patients with NCFB
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