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Etiology of non-cystic fibrosis bronchiectasis in adults and its correlation to disease severity

Lookup NU author(s): Professor Anthony De SoyzaORCiD, Emeritus Professor John Davison

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Abstract

Copyright © 2015 by the American Thoracic Society.Rationale: Testing for underlying etiology is a key part of bronchiectasis management, but it is unclear whether the same extent of testing is required across the spectrum of disease severity. Objectives: The aim of the present study was to identify the etiology of bronchiectasis across European cohorts and according to different levels of disease severity. Methods: We conducted an analysis of seven databases of adult outpatients with bronchiectasis prospectively enrolled at the bronchiectasis clinics of university teaching hospitals in Monza, Italy; Dundee and Newcastle, United Kingdom; Leuven, Belgium; Barcelona, Spain; Athens, Greece; and Galway, Ireland. All the patients at every site underwent the same comprehensive diagnostic workup as suggested by the British Thoracic Society. Measurements and Main Results: Among the 1,258 patients enrolled, an etiology of bronchiectasis was determined in 60%, including postinfective (20%), chronic obstructive pulmonary disease related (15%), connective tissue disease related (10%), immunodeficiency related (5.8%), and asthma related (3.3%). An etiology leading to a change in patient's management was identified in 13% of the cases. No significant differences in the etiology of bronchiectasis were present across different levels of disease severity, with the exception of a higher prevalence of chronic obstructive pulmonary disease-related bronchiectasis (P<0.001) and a lower prevalence of idiopathic bronchiectasis (P = 0.029) in patients with severe disease. Conclusions: Physicians should not be guided by disease severity in suspecting specific etiologies in patients with bronchiectasis, although idiopathic bronchiectasis appears to be less common in patients with the most severe disease.

Publication metadata

Author(s): Lonni S, Chalmers JD, Goeminne PC, McDonnell MJ, Dimakou K, De Soyza A, Polverino E, Van De Kerkhove C, Rutherford R, Davison J, Rosales E, Pesci A, Restrepo MI, Torres A, Aliberti S

Publication type: Article

Publication status: Published

Journal: Annals of the American Thoracic Society

Year: 2015

Volume: 12

Issue: 12

Pages: 1764-1770

Print publication date: 01/12/2015

Acceptance date: 01/10/2015

ISSN (print): 2325-6621

ISSN (electronic): 2325-6621

Publisher: American Thoracic Society

URL: https://doi.org/10.1513/AnnalsATS.201507-472OC

DOI: 10.1513/AnnalsATS.201507-472OC

PubMed id: 26431397

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