Bronchiectasis: do we need aetiological investigation?

Bronchiectasis (BE) is characterized by irreversible dilation and damage to the bronchial walls. It is a morphological expression of a large variety of pathologies. The true prevalence of BE is unknown. It is known, however, that in Third World countries it is common due to lung infections. Its current prevalence in developed countries is rather significant due to a greater capacity for diagnosis, its association with highly prevalent diseases and to a greater chronicity of some of the underlying pathologies. Over the last few decades there has been little interest in the investigation of BE, unless it is associated with cystic fibrosis. One of the reasons is the presupposition that treatment is the same for all patients diagnosed with BE, regardless of the underlying aetiology. Several works carried out over the last decade show that a diagnosis based on aetiology changes both the approach and the treatment of BE within a relevant percentage of patients, with a consequent change in the prognosis. Currently, systematic investigation into the aetiology of BE is recommended, particularly in those disorders that respond to specific treatment.