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[Bronchiectasis in adults: Etiological diagnosis].

C Martin1, L Regard1, G Chassagnon2

  • 1Service de pneumologie, centre de référence maladies rares mucoviscidose et affections liées à une anomalie de CFTR (site coordonnateur), hôpital Cochin, Assistance publique des hôpitaux de Paris (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.

Revue De Pneumologie Clinique
|October 16, 2018
PubMed
Summary

Bronchiectasis, an irreversible airway widening, is diagnosed via CT scan. Identifying its cause, especially in diffuse cases, involves various tests, aiding treatment and genetic counseling.

Keywords:
Airway infectionAllergic broncho-pulmonary aspergillosisAspergillose broncho-pulmonaire allergiqueClairance muco-ciliaireCystic fibrosisDyskinésie ciliaire primitiveDéficit immunitaireImmune deficiencyInfection pulmonaireMuco-ciliary clearanceMucoviscidosePrimary ciliary dyskinesia

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Area of Science:

  • Pulmonology
  • Radiology
  • Genetics

Background:

  • Bronchiectasis is defined as permanent, irreversible airway dilation.
  • Diagnosis relies on computed tomography (CT) scans, distinguishing localized from diffuse forms.
  • Localized bronchiectasis often has a specific cause, while diffuse forms have multiple potential etiologies.

Purpose of the Study:

  • To outline the diagnostic approach for bronchiectasis.
  • To categorize the causes of diffuse bronchiectasis.
  • To emphasize the importance of etiological diagnosis for treatment and counseling.

Main Methods:

  • Computed tomography (CT) for diagnosis and classification.
  • Bronchoscopy for etiological diagnosis in localized bronchiectasis.
  • Standardized biological tests and specialized explorations for diffuse bronchiectasis.

Main Results:

  • Diffuse bronchiectasis causes are grouped into immune deficiencies, genetic disorders, autoinflammatory/connective tissue diseases, chronic inflammatory/infectious disorders, and sequelae of pulmonary insults.
  • An etiological diagnosis is achieved in approximately 60% of cases following a systematic investigation.
  • Idiopathic bronchiectasis is diagnosed when no specific cause is identified.

Conclusions:

  • A systematic diagnostic approach is crucial for identifying the causes of bronchiectasis.
  • Etiological diagnosis can guide therapeutic strategies and inform genetic counseling.
  • Further specialized investigations may be necessary when initial tests are inconclusive.