Bronchiectasis

Bronchietasis is a chronic lung disease characterized by irreversible dilation and anatomical distortion of the airways or bronchi due to recurrent infections and inflammation of the respiratory tract. Clinically, bronchiectasis is suspected when a productive cough with sputum persists for more than four weeks and recurs more than three times. It is diagnosed radiologically when chest CT shows a bronchial lumen diameter greater than that of the adjacent artery within 5 mm (in children, bronchial lumen/arterial diameter > 0.8).

• Chronic productive cough with or without exertional dyspnea (the most common)
• Recurrent wheezing and respiratory infections, hemoptysis
• Growth retardation, digital clubbing, or pulmonary hyperinflation

On auscultation, coarse crackles may be heard, though breath sounds may also be normal. C34 wheezing may occur due to increased airway secretions and narrowing, and airway hyperresponsiveness can develop.

Immune dysfunction

• Severe combined immunodeficiency, unclassified immunodeficiency, NK cell deficiency, X-linked lymphoproliferative syndrome, ectodermal dysplasia, ataxia- telangiectasia, T-cell deficiency, cartilage-hair hypoplasia

Ciliary motility disorder

• Primary or functional

Mucus abnormalities

• Cystic fibrosis

Clinical syndromes

• Young’s syndrome, yellow nail lymphedema syndrome, Marfan syndrome, Usher syndrome

Congenital tracheobronchial dilation

• Mounier-Kuhn syndrome, Williams-Campbell syndrome, Ehlers-Danlos syndrome

Aspiration syndromes

• Recurrent microaspiration, primary aspiration, tracheoesophageal fistula, gastroesophageal reflux

Obstructive bronchiectasis

• Foreign body, tumor, lymph node

Lung diseases

• Interstitial lung disease, bronchiolitis obliterans, allergic bronchopulmonary aspergillosis, bronchopulmonary dysplasia, tracheobronchomalacia

Others

• Alpha-1 antitrypsin deficiency, protease inhibitor deficiency, organ transplantation, autoimmune disease, toxic smoke inhalation, eosinophilic lung disease