Phenotyping adults with non-cystic fibrosis bronchiectasis: A prospective observational cohort study

Abstract

IB and PIB accounted for two thirds of cases of bronchiectasis in a general population. We recommend routine screening for ABPA and total immunoglobulin deficiency but not for other rarer aetiologies.

The heterogeneity of systemic inflammation in bronchiectasis

“…However, differentiating between idiopathic and postinfectious bronchiectasis is challenging because patients classified as idiopathic may have had unreported respiratory infection, and where bronchiectasis is classified as postinfectious there may be recall bias with tenuous linkage to a previous, often childhood, infection. Anwar et al [13] suggested that post-infectious bronchiectasis may be a valid subgroup as patients had an earlier onset of disease, but evidence to date as to whether idiopathic and post-infectious disease are separate phenotypes remains inconclusive. Our data demonstrate that these aetiologies are difficult to differentiate in terms of systemic inflammatory profiles.…”

Diagnostic challenges of bronchiectasis

“…The entities that have been associated with the development of bronchiectasis are numerous, and their prevalence varies depending on the population studied. Most studies directed to characterising patients with bronchiectasis to date have focused on specific populations in the UK, which can make it difficult to extrapolate the results to other countries and outside of highly specialised centres [4][5][6]. Recently, Lonni and colleagues conducted an analysis of 1,258 patients from seven cohorts in different countries included in the European Bronchiectasis Registry (EMBARC) in the study directed to the most extensive identification of aetiologies of bronchiectasis to date [7].…”

“…This is the most frequently identified aetiology in most studies with a prevalence of 10-32% [4][5][6][7][8]. This variability may be due to a higher prevalence of postinfectious aetiology in the most disadvantaged communities [9].…”

“…Bronchiectasis has also been associated with other chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) [3]. In addition, recent studies focusing on the aetiology of bronchiectasis has revealed a high percentage of patients with no identifiable cause despite undergoing extensive studies for this purpose that are considered idiopathic [4][5][6][7].…”

“…Some bronchiectasis aetiologies can determine a change in patient management such as initiating a specific treatment, closer follow-up, genetic testing for relatives or modifying risk factors [6,7]. Therefore, it is important to identify the aetiological cause of the bronchiectasis for a proper management.…”