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Early radiographic and clinical features associated with bronchiectasis in children

Gregory Redding1, Rosalyn Singleton, Toby Lewis

  • 1Pediatric Pulmonary Division, University of Washington School of Medicine, Seattle, Washington 98105, USA. gredding@u.washington.edu

Pediatric Pulmonology
|March 17, 2004
PubMed

Insights

Severe childhood respiratory infections, particularly pneumonia, increase bronchiectasis risk in Alaska Native children. Early lung parenchymal densities on radiographs are key indicators, not solely respiratory syncytial virus (RSV) infection.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Radiology

Background:

  • Bronchiectasis in developing regions is linked to early childhood respiratory infections.
  • Specific risk factors preceding childhood bronchiectasis remain unclear.
  • Severe respiratory syncytial viral (RSV) infection is hypothesized as a risk factor for bronchiectasis in Alaska Native children.

Purpose of the Study:

  • To investigate the association between severe RSV infection in infancy and the risk of developing bronchiectasis.
  • To identify specific radiographic risk factors for childhood bronchiectasis in a rural Alaska Native population.

Main Methods:

  • Follow-up cohort study of a previous case-control study involving RSV-hospitalized children and controls.
  • Review of medical records, parental interviews, physical examinations, spirometry, serum collection, and chest radiograph analysis for children aged 5-8 years.
  • Radiographic assessment for evidence of bronchiectasis and associated lung parenchymal changes.

Main Results:

  • 10 (11%) RSV cases and 10 (9%) controls showed radiographic evidence of bronchiectasis.
  • Children with bronchiectasis were more likely to have lung parenchymal densities (< 2 years old) (RR=3.9), persistent densities (>6 months) (RR=3.0), or multiple infiltrates (P=0.003).
  • Hyperinflation and atelectasis in early childhood were not associated with subsequent bronchiectasis; severe RSV infection alone did not predispose infants.

Conclusions:

  • Childhood bronchiectasis in this cohort was associated with lung injury, specifically parenchymal densities (pneumonia), rather than hyperinflation or atelectasis.
  • Early radiographic evidence of lung parenchymal densities is a significant predictor of childhood bronchiectasis.
  • Severe RSV infection alone is not a sufficient risk factor; rather, the resulting lung injury is key.

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