Factors Affecting the Outcome of Bronchiectasis in Pediatric Patients

Authors

1 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Pediatrician.

3 Internist.

Abstract

Introduction: Bronchiectasis is a common problem in children and early diagnosis
can lead to early treatment and prevent of its complications. This study was aimed
to evaluate factors effective on outcome of bronchiectasis in children.
Methods: In an analytical cross-sectional study, 347 children with bronchiectasis
Underwent the study. the patients were diagnosed based on chronic
suppurative cough and CT scan findings.
.
Results:
Disease etiology was asthma in 55.6%, Gastroesophagial
reflux (GERD) in 7.8%, Cystic fibrosis (CF) in 4.8%, other causes in 11.2% and
idiopathic in 20.6%. All cases complained of chronic cough. The most common
sign was daily sputum production (79.1%) and common symptoms were ral/crackle
in 47.1% and wheezing in 25.4%. Mean treatment period was 32.82±11.56 months.
At the end of follow-up, complete improvement occurred in 35.6%, partial
improvement in 40.9% and no improvement in 23.5%.
Conclusion: In children with chronic cough and crackle in physical examination,
consideration of bronchiectasis could be helpful in early diagnosis and
complementary evaluations and treatment initiation. Treating the underlying
disease could prevent the occurrence and increase the response to treatment of
bronchiectasis.

Keywords


 

1. Alvarez Caro F, Gómez Farpón A, Ruiz del Árbol Sánchez P, de Miguel Mallén MÁ, Alvarez

Berciano  F.  Bronchiectasis  in  pediatrics,  diagnosis  approach  and  management.  Arch  Argent Pediatr. 2012;110(1):52-9.

2.  Masekela  R,  Green  RJ.  The  role  of  macrolides  in  childhood  non-cystic  fibrosis-related

bronchiectasis. Mediators Inflamm 2012;2012:134605.

3.  Habesoglu  MA,  Ugurlu  AO,  Eyuboglu  FO.  Clinical,  radiologic, and  functional evaluation  of  304 patients with bronchiectasis. Ann Thorac Med 2011;6(3):131-6.

4. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW. Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med 2006;100:2183-9.

5. Pasteur  MC,  Helliwell  SM,  Houghton  SJ,  Webb  SC,  Foweraker  JE,  Coulden  RA,  et  al.  An investigation into causative  factors in patients with bronchiectasis.  Am J  Respir Crit Care  Med 2000;162:1277-84.

6.  Feldman  C.  Bronchiectasis:  new  approaches  to  diagnosis  and  management.  Clinics  in  Chest Medicine 2011;32(3):535-46.

7. Dagli E. Non cystic fibrosis bronchiectasis. Paediatr Respir Rev 2000;1(1):64-70.

8.  Eastham  KM,  Fall  AJ,  Mitchell  L,  Spencer  DA.  The  need  to  redefine  non-cystic  fibrosis bronchiectasis in childhood. Thorax 2004;59(4):324-7.

9. Twiss J, Metcalfe R, Edwards E, Byrnes C. New Zealand national incidence of bronchiectasis

"too high" for a developed country. Arch Dis Child 2005;90(7):737-40.

10.  Sirmali  M,  Karasu  S,  Türüt  H,  Gezer  S,  Kaya  S,  Taştepe  I,  Karaoğlanoğlu  N.  Surgical management of bronchiectasis in childhood. Eur J Cardiothorac Surg 2007;31(1):120-3.

11. Barker AF. Bronchiectasis. N Engl J Med 2002;346:1383-93.

12.  King  PT,  Holdsworth  SR,  Freezer  NJ,  Villanueva  E,  Holmes  PW.  Characterisation  of  the onset and presenting clinical features of adult bronchiectasis. Respir Med 2006;100:2183-89.

13. King PT, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW. Outcome in

Adult Bronchiectasis. COPD: Journal of Chronic Obstructive Pulmonary Diseases 2005;2:27-34.

14.   King   PT.   The   pathophysiology   of   bronchiectasis.   Int   J   Chron   Obstruct   Pulmon   Dis 2009;4:411-9.

15. Fall A, Spencer D. Paediatric bronchiectasis in Europe: what now and where next?  Paediatr

Respir Rev 2006;7(4):268-74.

16.  Karakoc  GB,  Yilmaz  M,  Altintas  DU,  Kendirli  SG.  Bronchiectasis:  still  a  problem.  Pediatr Pulmonol 2001;32(2):175-8.

17. Karadag B, Karakoc F, Ersu R, Kut A, Bakac S, Dagli E. Non-cystic-fibrosis bronchiectasis in children: a persisting problem in developing countries. Respiration 2005;72(3):233-8.

18.  Pasteur  MC,  Helliwell  SM,  Houghton  SJ,  Webb  SC,  Foweraker JE,  Coulden  RA,  et  al.  An investigation into causative  factors in patients with bronchiectasis.  Am J  Respir Crit Care  Med 2000;162(4 Pt 1):1277-84.

19.  Nikolaizik  WH,  Warner  JO.  Aetiology  of  chronic  suppurative  lung  disease.  Archives  of Disease in Childhood 1994; 70: 141-2.

20. Kim HY, Kwon JW, Seo J, Song YH, Kim BJ, Yu J, et al. Bronchiectasis in children: 10-

year experience at a single institution. Allergy Asthma Immunol Res 2011;3(1):39-45.

21.  Li  AM,  Sonnappa  S,  Lex  C,  Wong  E,  Zacharasiewicz  A,  Bush  A,  et al.  Non-CF

bronchiectasis: does knowing the aetiology lead to changes in management?  Eur Respir J 2005

; 26(1):8-14.

22.  Edwards  EA,  Metcalfe  R,  Milne  DG,  Thompson  J,  Byrnes  CA.  Retrospective  review  of children   presenting   with   non   cystic   fibrosis   bronchiectasis:   HRCT   features   and   clinical relationships. Pediatr Pulmonol 2003;36:87-93.

23.  Ferkol  TW,  Davis  PB.  Bronchiectasis  and  bronchiolitis  obliterans.  In:  Taussig  LM,

Landau  LI,  Le  Souef  PN,  Morgan  WJ,  Martinez  FD,  Sly  PD  editors.  Pediatric  respiratory

Medicine 1999; St Louis, Mosby, 784-9.

24. Brown MA, Lemen RJ. Bronchiectasis. In: Chernick V, Boat TF, Kendig EL, ediors.

Kendig's disorders of respiratory tract in children. 6 th ed. Philadelphia: Saunders;1998. 538-52.

25. Baker A, Bardana E. Bronchiectasis: update of on orphan disease. Am Rev Respir Dis 1988;

137: 969-76.

26. Lai SH, Wong KS, Liao SL. Clinical analysis of bronchiectasis in Taiwanese children. Chang

Gung Med J 2004;27(2):122-8.

27. Pang J, Chan HS, Sung JY. Prevalence of asthma, atopy, and bronchial hyperreactivity

in bronchiectasis: a controlled study. Thorax 1989; 44, 948-51.

28.  Ip  MS,  So  SY,  Lam  WK,  Yam  L,  Liong  E.  High  prevalence  of  asthma  in  patients  with bronchiectasis in Hong Kong. Eur Respir J 1992;5(4):418-23.

29. Säynäjäkangas O, Keistinen T, Tuuponen T, Kivelä SL. Bronchiectasis in Finland: trends in

hospital treatment. Respir Med 1997;91(7):395-8.

30.  Chang  AB,  Redding  GJ,  Everard  ML.  Chronic  wet  cough:  Protracted  bronchitis,  chronic suppurative lung disease and bronchiectasis. Pediatr Pulmonol 2008;43(6):519-31.

31. Kothari NA, Kramer SS. Bronchial diseases and lung aeration in children. J Thorac Imaging.

2001;16(4):207-23.

32.   Banjar   HH.   Clinical   profile   of   Saudi   children   with   bronchiectasis.   Indian   J   Pediatr 2007;74(2):149-52.

33.  Coleman  LT,  Kramer  SS,  Markowitz  RI,  et  al.  Bronchiectasis  in  children.  J  Thorac  Imag 1995; 10: 268-79.

34. Kang E, Miller RR, Muller NL. Bronchiectasis: comparison of preoperative thin-section CT

and pathologic findings in resected specimens. Radiology 1995; 195: 649-54.

35.  McGuinness  G,  Naidich  DP.  CT  of  airways  disease  and  bronchiectasis.  Radiol  Clin  North Am 2002;40:1-19.

36. English BK, Schroeder HW, Wilson CB. Immaturity of the fetal and neonatal immune system. In: Rich RR, Fleisher TA, Shearer WT, Kotzin BL, Schroeder HW, editors. Clinical Immunology, Principles and Practice. London, UK: Mosby; 2001. pp. 40.10-40.41.

37. Weksler ME, Szabo P. Aging and the immune system. In: Rich RR, Fleicher TA, Shearer WT, Kotzin BL, Schroeder HW, editors. Clinical Immunology; Principles and Practice.  London, UK: Mosby; 2001. pp. 41.41-48.

38.  Pasteur  MC,  Helliwell  SM,  Houghton  SJ,  et  al.  An  investigation  into  causative  factors  in patients with bronchiectasis. Am J Respir Crit Care Med 2000;162:1277-84.

39. Dagli E. Non cystic fibrosis bronchiectasis. Paediatr Respir Rev 2000; 1: 64-70.

40.  Lewinston  NJ.  Bronchiectasis.  In:  Hilman  BC,  editor.  Pediatric  respiratory  disease:

diagnosis and treatment . Philadelphia: Saunders:1993.p. 222.

41.  Al-Shirawi  N,  Al-Jahdali  HH,  Al-Shimemeri  A.  Pathogenesis,  etiology  and  treatment  of  bronchiectasis. Ann Thorac Med 2006; 1(1), 41-51.

42. Caylak H, Genc O, Kavakli K, Gurkok S, Gozubuyuk A, Yucel O, et al. Surgical management of   bronchiectasis:   a   collective   review   of   339   patients   with   long-term   follow-up.   Thorac Cardiovasc Surg 2011;59(8):479-83.

43.  Redding  GJ.  Update  on  treatment  of  childhood  bronchiectasis  unrelated  to  cystic-fibrosis. Paediatr Respir Rev 2011;12(2):119-23.