Non-cystic-fibrosis bronchiectasis: A perspective from South America

Maróstica, Paulo José Cauduro; Fischer, Gilberto Bueno

doi:10.1016/j.prrv.2006.04.008

Cited by 15 publications

(15 citation statements)

References 39 publications

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“…In indigenous children <15 years of age from remote communities in Australia the prevalence rate of HRCT-confirmed bronchiectasis was estimated to be 14.7/1000 [57]. There are many other pathologies that can contribute to bronchiectasis development apart from TB, eg, pertussis, influenza, congenital malformations or foreign body aspiration [58]. In Alaska native children and adults, only 4% of patients with probable (defined by clinical and CXR findings) and definite (diagnosed by bronchogram or CT) bronchiectasis had a history of pulmonary TB.…”

Section: Discussionmentioning

confidence: 99%

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

et al. 2014

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BackgroundInterferon-gamma release assays have emerged as a more specific alternative to the tuberculin skin test (TST) for detection of tuberculosis (TB) infection, especially in Bacille Calmette-Guérin (BCG) vaccinated people. We determined the prevalence of Mycobacterium tuberculosis infection by TST and QuantiFERON®-TB Gold In-Tube (QFT-GIT) and assessed agreement between the two test methods and factors associated with positivity in either test in Warao Amerindian children in Venezuela. Furthermore, progression to active TB disease was evaluated for up to 12 months.Methods163 HIV-negative childhood household contacts under 16 years of age were enrolled for TST, QFT-GIT and chest X-ray (CXR). Follow-up was performed at six and 12 months. Factors associated with TST and QFT-GIT positivity were studied using generalized estimation equations logistic regression models.ResultsAt baseline, the proportion of TST positive children was similar to the proportion of children with a positive QFT-GIT (47% vs. 42%, p = 0.12). Overall concordance between QFT-GIT and TST was substantial (kappa 0.76, 95% CI 0.46-1.06). Previous BCG vaccination was not associated with significantly increased positivity in either test (OR 0.68, 95% CI 0.32-1.5 for TST and OR 0.51, 95% CI 0.14-1.9 for QFT-GIT). Eleven children were diagnosed with active TB at baseline. QFT-GIT had a higher sensitivity for active TB (88%, 95% CI 47-98%) than TST (55%, 95% CI 24-83%) while specificities were similar (respectively 58% and 55%). Five initially asymptomatic childhood contacts progressed to active TB disease during follow-up.ConclusionReplacement of TST by the QFT-GIT for detection of M. tuberculosis infection is not recommended in this resource-constrained setting as test results showed substantial concordance and TST positivity was not affected by previous BCG vaccination. The QFT-GIT had a higher sensitivity than the TST for the detection of TB disease. However, the value of the QFT-GIT as an adjunct in diagnosing TB disease is limited by a high variability in QFT-GIT results over time.

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Section: Discussionmentioning

confidence: 99%

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

et al. 2014

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“…Authors from South America,46 Hong Kong/China,47 India,48 and Turkey49 all report that bronchiectasis is an important local problem. It is certainly a major problem in certain indigenous populations such as Australian aborigines, New Zealand Maori, and Alaskan natives 50–52.…”

Section: Etiologic Factorsmentioning

confidence: 99%

The pathophysiology of bronchiectasis

King¹

2009

COPD

171

139

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Bronchiectasis is defined by permanent and abnormal widening of the bronchi. This process occurs in the context of chronic airway infection and inflammation. It is usually diagnosed using computed tomography scanning to visualize the larger bronchi. Bronchiectasis is also characterized by mild to moderate airflow obstruction. This review will describe the pathophysiology of noncystic fibrosis bronchiectasis. Studies have demonstrated that the small airways in bronchiectasis are obstructed from an inflammatory infiltrate in the wall. As most of the bronchial tree is composed of small airways, the net effect is obstruction. The bronchial wall is typically thickened by an inflammatory infiltrate of lymphocytes and macrophages which may form lymphoid follicles. It has recently been demonstrated that patients with bronchiectasis have a progressive decline in lung function. There are a large number of etiologic risk factors associated with bronchiectasis. As there is generally a long-term retrospective history, it may be difficult to determine the exact role of such factors in the pathogenesis. Extremes of age and smoking/chronic obstructive pulmonary disease may be important considerations. There are a variety of different pathogens involved in bronchiectasis, but a common finding despite the presence of purulent sputum is failure to identify any pathogenic microorganisms. The bacterial flora appears to change with progression of disease.

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“…Su frecuencia oscila, en adultos y niños, en 0-17%. 18,[40][41][42] Dentro de las adquiridas, además de la inmunodepresión farmacológica, destaca la infección VIH (sida). Las bronquiectasias son más frecuentes en pacientes con neumonía intersticial linfoide, neumonías bacterianas o protozoarias recurrentes, o mayor grado de inmunodepresión, especialmente si los linfocitos CD 4+ son menores de 100/mcL.…”

Section: Inmunodeficienciasunclassified

“…43,44 De las congénitas, las humorales son las que más se asocian a bronquiectasias, destacando la agammaglobulinemia ligada al cromosoma X, la inmunodeficiencia común variable, y déficit de subclases de inmunoglobulinas. 18,[40][41][42] El déficit de IgA, déficit inmunológico más frecuente, se ha asociado a bronquiectasias, pero existe discrepancia al respecto. 45,46 Los gérmenes son clásicamente encapsulados (S. pneumoniae, H. influenzae).…”

Section: Inmunodeficienciasunclassified

Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

et al. 2012

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RESUMENLas bronquiectasias son un problema de salud en países desarrollados y en vías de desarrollo. La fibrosis quística es una causa importante, si bien fuera de ésta existen causas que convierten a las bronquiectasias no relacionadas con fibrosis quística en un diagnóstico frecuente. Su diagnóstico precoz basado en la clínica y posterior confirmación radiológica es el punto de partida para determinar la etiología e instaurar un tratamiento dirigido a la causa subyacente. Para ello es menester una evaluación ordenada y sistemá-tica. Se presenta una revisión sobre la etiología y tratamiento de las bronquiectasias, especialmente de las no relacionadas con fibrosis quística. Palabras clave: bronquiectasias, fibrosis quística, antibióticos, infección bronquial, diagnóstico. SUMMARYBronchiectasis is still an important health problem in both, developed and developing countries. Cystic fibrosis is one of the most important causes, but a great variety of other causes makes non cystic fibrosis bronchiectasis a relatively frequent diagnosis. Early diagnosis based on medical history and radiological confirmation is only the starting point to determine the specific etiology, in order to establish a treatment focused on the underlying cause. For this purpose, an orderly and systematic diagnostic evaluation is required. A review article about bronchiectasis, particularly those not related to cystic fibrosis, is presented.

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Non-cystic-fibrosis bronchiectasis: A perspective from South America

Cited by 15 publications

References 39 publications

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

The pathophysiology of bronchiectasis

Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

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