Pathophysiology, causes and genetics of paediatric and adult bronchiectasis

Respirology : Official Journal of the Asian Pacific Society of Respirology
Andrew Bush, R Andres Floto

Abstract

Bronchiectasis has historically been considered to be irreversible dilatation of the airways, but with modern imaging techniques it has been proposed that 'irreversible' be dropped from the definition. The upper limit of normal for the ratio of airway to arterial development increases with age, and a developmental perspective is essential. Bronchiectasis (and persistent bacterial bronchitis, PBB) is a descriptive term and not a diagnosis, and should be the start not the end of the patient's diagnostic journey. PBB, characterized by airway infection and neutrophilic inflammation but without significant airway dilatation may be a precursor of bronchiectasis, and there are many commonalities in the microbiology and the pathology, which are reviewed in this article. A high index of suspicion is essential, and a history of chronic wet or productive cough for more than 4-8 weeks should prompt investigation. There are numerous underlying causes of bronchiectasis, although in many cases no cause is found. Causes include post-infectious, especially after tuberculosis, adenoviral or pertussis infection; aspiration syndromes; defects in host defence, which may solely affect the airways (cystic fibrosis, not considered in this review, and ...Continue Reading

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Citations

Aug 20, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Adam T Hill, Anne B Chang
Feb 25, 2020·Case Reports in Medicine·Xi-Ling WuZhi-Min Chen
Jun 4, 2021·Journal of Asthma and Allergy·Andrew J WardlawCatherine H Pashley
Jul 15, 2021·Seminars in Respiratory and Critical Care Medicine·Holly R Keir, James D Chalmers

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