Non cystic fibrosis-related bronchiectasis in children: etiological structure, clinical and laboratory and computed tomographic characteristics

Abstract

Aim. To establish the etiological structure and to present clinical and laboratory and instrumental characteristics of bronchiectasis (BE) not associated with cystic fibrosis (CF) in children.
 Materials and methods. Sixty-seven hospitalised patients with BЕ not related to CF were followed up between 2017 and 2022. Examination methods: clinical-anamnestic method, general clinical laboratory investigations, investigation of allergological and immune status, phagocytosis system, determination of concentration of specific IgE and IgG to fungi of genus Aspergillus, sweat test, radiological examination and computed tomography (CT) of chest organs, bronchoscopy, Bacteriological examination of sputum and/or tracheobronchial aspirates, nasal and/or bronchial ciliary motility, esophagogastroduodenoscopy, 24-hour pH-metry, intra-esophageal combined impedance-pH-metry, genetic study, lung biopsy.
 Results. Etiologic factors of BЕ not associated with CF in children were severe pneumonia (22%), primary ciliary dyskinesia (22%), bronchial asthma (13%), Williams-Campbell syndrome (7%), bronchial foreign bodies (7%), gastroesophageal reflux disease (6%), Bronchopulmonary dysplasia (6%), postinfectious bronchiolitis obliterans (5%), allergic bronchopulmonary aspergillosis (3%), chronic granulomatous disease (3%), AIDS (1%), prolonged bacterial bronchitis (1%), brain-lung-thyroid syndrome (1%). The clinical picture is characterized by cough (91%), shortness of breath (67%), fever during exacerbation (48%), chest pain (24%), exercise intolerance (55%), drumstick symptom (9%), moist (76%) and dry wheezing (37%). CT-semiotics of BЕ not associated with CF is characterized by localization in one (58%) or several (42%) lobes; traction (42%), non-traction (49%) B and their combination (9%); increased broncho-arterial ratio 0.9; thickening of bronchial wall; "mosaic perfusion"/"air-trap" symptom (9%); more frequent involvement of lower lungs (64%). The main infectious agents in BЕ not associated with CF were Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus.
 Conclusion. On the basis of a multicentre study, the etiological structure, clinical and laboratory and CT-characteristics of non-CF ВE in children were established.

120 years of Morozov Children’s City Clinical Hospital: clinic, science, education

“…Вместе с тем, самым частым хроническим заболеванием легких у детей является бронхиальная астма. Оказание помощи детям с данным заболеванием, госпитализированным в МДГКБ, чаще с неконтролируемым течением, подтверждает ее клиническую гетерогенность, возможность атипичной манифестации, включающей такие проявления, как астматический бронхит, хронический сухой кашель, затяжной бактериальный бронхит, рецидивирующий синдром крупа, рецидивирующая пневмония, синдром средней доли, бронхоэктазы, синдромы утечки воздуха (пневмоторакс, пневмомедиастинум, подкожная эмфизема), пластический бронхит [42,[44][45][46]. В терапию больных тяжелой астмой внедрены биологические препараты (омализумаб, дупилумаб).…”