Non-cystic fibrosis bronchiectasis in childhood: longitudinal growth and lung function

Bastardo, Cristina; Sonnappa, Samatha; Stanojevic, Sanja; Navarro, Adria E.; López, Paola; Jaffé, Adam; Bush, Andrew

doi:10.1136/thx.2008.100958

Cited by 75 publications

(85 citation statements)

References 24 publications

(30 reference statements)

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“…Second, our fi ndings also indicate that age-matching and control groups are necessary for therapeutic trials in which AREs are an outcome measure of effi cacy, given that all participants experienced fewer AREs over time. Last, our data support previous studies 22, 26,27 showing that comprehensive medical care improves outcomes. Data from several retrospective cohort studies have shown that optimized respiratory care improves initial lung function and prevents medium-term lung function decline.…”

Section: Predisposing Factors For Recurrent and Severe Aressupporting

confidence: 81%

“…Data from several retrospective cohort studies have shown that optimized respiratory care improves initial lung function and prevents medium-term lung function decline. 22,26,27 Th is study has several limitations. Although AREs were defi ned a priori, the defi nition was intentionally broad and based on the variable features of an ARE in children with HRCT scan-confi rmed bronchiectasis.…”

Section: Predisposing Factors For Recurrent and Severe Aresmentioning

confidence: 99%

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Respiratory Exacerbations in Indigenous Children From Two Countries With Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis

Redding

Singleton

Valery

et al. 2014

Chest

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Section: Predisposing Factors For Recurrent and Severe Aressupporting

confidence: 81%

Section: Predisposing Factors For Recurrent and Severe Aresmentioning

confidence: 99%

Respiratory Exacerbations in Indigenous Children From Two Countries With Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis

Redding

Singleton

Valery

et al. 2014

Chest

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“…There is increasing evidence for improved outcomes with earlier diagnosis and treatment of bronchiectasis (5,(8)(9)(10)18,19), and this is potentially true for the type of patient we describe. An Australian study of adults with newly diagnosed bronchiectasis showed correlation between the decline in FEV 1 and the duration of cough (20).…”

Section: A B a B Discussionmentioning

confidence: 99%

“…An Australian study of adults with newly diagnosed bronchiectasis showed correlation between the decline in FEV 1 and the duration of cough (20). Longitudinal data in children with bronchiectasis suggest that early diagnosis and intensive treatment slows deterioration of lung function (9,10). Gharagozlou showed that in patients with primary hypogammaglobulinemia, there had been a longer delay in diagnosis among those who developed bronchiectasis compared to those who did not (21).…”

Section: A B a B Discussionmentioning

confidence: 99%

“…This definition has been challenged in the pediatric literature due to the prevalence of children with clinical characteristics similar to bronchiectasis, but without bronchial dilatation, leading to the term chronic suppurative lung disease (CSLD) (4)(5)(6)(7). Emerging data suggest that early diagnosis and intensive therapy may slow the decline in lung function and lead to improved outcomes in these patients (5,(8)(9)(10). A widely accepted paradigm in the pediatric literature is that a continuum of disease exists, with "pre-bronchiectasis" representing a stage of productive purulent cough, and frequent pulmonary infections without airway dilatation (5,11,12).…”

Section: Introductionmentioning

confidence: 99%

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Chronic suppurative lung disease in adults

Metersky

Mangardich

2016

J. Thorac. Dis.

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Chronic suppurative lung disease (CSLD), characterized by a bronchiectasis-like syndrome in the absence of bronchial dilatation, is well described in the pediatric literature. In some patients, it may be a precursor of bronchiectasis. In adults, this syndrome has not been well described. We present four adult patients without obvious causative exposures who presented with prolonged cough and purulent sputum.Sputum cultures revealed a variety of Gram negative bacteria, fungi and mycobacteria. High resolution CT scanning did not reveal bronchiectasis. Evaluation revealed underlying causes including immunodeficiency in two, and Mycobacterium avium infection. One patient subsequently developed bronchiectasis. All patients improved with therapy. CSLD occurs in adults and has characteristics that distinguish it from typical chronic bronchitis. These include the lack of causative environmental exposures and infection with unusual pathogens. Evaluation and treatment of these patients similar to bronchiectasis patients may lead to clinical improvement. J Thorac Dis 2016;8(9):E974-E978 jtd.amegroups.com level were normal. He was now producing a half cup of yellow-green sputum daily, thus it was felt that he was a good candidate for azithromycin at 250 mg 3 times a week, as would be indicated for bronchiectasis patients. Three months later, he reported an "80% improvement" in his cough, which was then productive of only scant clear sputum and he has continued to do well with azithromycin and an airway clearance regimen. Case 2A 66-year-old male with a history of life-long asthma which was reasonably well controlled without systemic steroids, was referred for a several year history of daily cough of approximately a tablespoon of yellow sputum. His respiratory symptoms periodically worsened, and he experienced six exacerbations requiring antibiotics in the year prior to his referral. He had a 12-pack-year smoking history, discontinued more than 20 years previously. Physical examination was significant for a wet cough, rhinitis and diminished breath sounds at the lung bases. Spirometry testing showed borderline low FEV 1 /FVC ratio of 71% and sagging of the expiratory loop, but an FEV 1 of 111% of predicted and no bronchodilator response. Blood work showed an elevated IgE level at 590 kU/L. Other immunoglobulins, alpha-1 antitrypsin level and a cystic fibrosis (CF) mutation screen were normal. Sputum cultures showed Aspergillus fumigatus, Bordetella bronchiseptica, Pseudomonas aer uginosa and Mycobacterium avium complex (MAC). Aspergillus IgG and IgE were elevated, although the IgE elevation was borderline (0.47 kU/L, upper limit of normal 0.32 kU/L), suggesting the possibility of allergic bronchopulmonary aspergillosis. An HRCT from approximately 3 years prior to his referral, but after the onset of symptoms, demonstrated some areas of bronchial wall thickening but no bronchiectasis (Figure 2A). A HRCT after his referral demonstrated bronchiectasis, bronchial wall thickening and mucus impaction in his left lower lo...

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