Changing clinical characteristics of non-cystic fibrosis bronchiectasis in children.
Adolescent
Bronchiectasis
/ etiology
Child
Child, Preschool
Ciliary Motility Disorders
/ complications
Cohort Studies
Female
Humans
Infant
Infections
/ complications
Male
Primary Immunodeficiency Diseases
/ complications
Respiratory Function Tests
Severity of Illness Index
Spirometry
Sputum
/ microbiology
Bronchiectasis
Child
Primary ciliary dyskinesia
Spirometry
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
16 Jun 2020
16 Jun 2020
Historique:
received:
20
09
2019
accepted:
11
06
2020
entrez:
18
6
2020
pubmed:
18
6
2020
medline:
9
3
2021
Statut:
epublish
Résumé
The prevalence of non-cystic fibrosis (CF) bronchiectasis is increasing in both developed and developing countries in recent years. Although the main features remain similar, etiologies seem to change. Our aim was to evaluate the clinical and laboratory characteristics of our recent non-CF bronchiectasis patients and to compare these with our historical cohort in 2001. One hundred four children with non-CF bronchiectasis followed between 2002 and 2019 were enrolled. Age of diagnosis, underlying etiology and microorganisms in sputum culture were recorded. Clinical outcomes were evaluated in terms of lung function tests and annual pulmonary exacerbation rates at presentation and within the last 12 months. Mean FEV1 and FVC %predicted at presentation improved compared to historical cohort (76.6 ± 17.1 vs. 63.3 ± 22.1 and 76.6 ± 15.1 vs. 67.3 ± 23.1, respectively; p < 0.001). There was a significant decrease in pulmonary exacerbation rate from 6.05 ± 2.88 at presentation to 3.23 ± 2.08 during follow-up (p < 0.0001). In 80.8% of patients, an underlying etiology was identified. There was an increase in primary ciliary dyskinesia (PCD) (32.7% vs. 6.3%; p = 0.001), decrease in idiopathic cases (19.2% vs. 37.8%; p = 0.03) with no change in postinfectious and immunodeficiencies as underlying etiology. Sputum cultures were positive in 77.9% of patients which was 46.9% in the historical cohort (p = 0.001). Baseline pulmonary function tests were better and distribution of underlying etiology had changed with a remarkable increase in diagnosis of PCD in the recent cohort.
Sections du résumé
BACKGROUND
BACKGROUND
The prevalence of non-cystic fibrosis (CF) bronchiectasis is increasing in both developed and developing countries in recent years. Although the main features remain similar, etiologies seem to change. Our aim was to evaluate the clinical and laboratory characteristics of our recent non-CF bronchiectasis patients and to compare these with our historical cohort in 2001.
METHODS
METHODS
One hundred four children with non-CF bronchiectasis followed between 2002 and 2019 were enrolled. Age of diagnosis, underlying etiology and microorganisms in sputum culture were recorded. Clinical outcomes were evaluated in terms of lung function tests and annual pulmonary exacerbation rates at presentation and within the last 12 months.
RESULTS
RESULTS
Mean FEV1 and FVC %predicted at presentation improved compared to historical cohort (76.6 ± 17.1 vs. 63.3 ± 22.1 and 76.6 ± 15.1 vs. 67.3 ± 23.1, respectively; p < 0.001). There was a significant decrease in pulmonary exacerbation rate from 6.05 ± 2.88 at presentation to 3.23 ± 2.08 during follow-up (p < 0.0001). In 80.8% of patients, an underlying etiology was identified. There was an increase in primary ciliary dyskinesia (PCD) (32.7% vs. 6.3%; p = 0.001), decrease in idiopathic cases (19.2% vs. 37.8%; p = 0.03) with no change in postinfectious and immunodeficiencies as underlying etiology. Sputum cultures were positive in 77.9% of patients which was 46.9% in the historical cohort (p = 0.001).
CONCLUSION
CONCLUSIONS
Baseline pulmonary function tests were better and distribution of underlying etiology had changed with a remarkable increase in diagnosis of PCD in the recent cohort.
Identifiants
pubmed: 32546272
doi: 10.1186/s12890-020-01214-7
pii: 10.1186/s12890-020-01214-7
pmc: PMC7298950
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
172Références
Pediatr Pulmonol. 2012 Mar;47(3):300-7
pubmed: 21901858
BMC Pediatr. 2014 Dec 10;14:4
pubmed: 25492164
Med J Aust. 2015 Jan 19;202(1):21-3
pubmed: 25588439
Chest. 2010 Jul;138(1):158-64
pubmed: 20173055
Pediatr Pulmonol. 2011 Feb;46(2):131-8
pubmed: 20717910
Eur Respir J. 2018 Aug 23;52(2):
pubmed: 30049738
Thorax. 2009 Mar;64(3):246-51
pubmed: 19052050
Paediatr Respir Rev. 2011 Jun;12(2):91-6
pubmed: 21458736
Thorax. 2004 Apr;59(4):324-7
pubmed: 15047953
Pediatr Pulmonol. 2003 Aug;36(2):87-93
pubmed: 12833486
Thorax. 2010 Jul;65 Suppl 1:i1-58
pubmed: 20627931
Pediatr Pulmonol. 2001 Aug;32(2):175-8
pubmed: 11477735
Respir Med. 2019 May;151:121-127
pubmed: 31047108
Turk J Pediatr. 2016;58(1):19-26
pubmed: 27922232
Eur Respir J. 2005 Jul;26(1):8-14
pubmed: 15994383
Front Pediatr. 2017 May 29;5:123
pubmed: 28611970
Respir Med. 2009 Nov;103(11):1681-7
pubmed: 19501498
Ann Am Thorac Soc. 2013 Dec;10(6):574-81
pubmed: 24024753
Eur Respir J. 2016 Jan;47(1):186-93
pubmed: 26541539
Indian J Pediatr. 2007 Feb;74(2):149-52
pubmed: 17337827
Front Pediatr. 2017 Feb 20;5:27
pubmed: 28265556
Pediatr Pulmonol. 2012 Jan;47(1):68-75
pubmed: 21830316
Lancet Respir Med. 2013 Oct;1(8):610-620
pubmed: 24461664
Pediatr Pulmonol. 2000 Mar;29(3):182-7
pubmed: 10686038
Respir Med. 2018 Apr;137:35-39
pubmed: 29605210
Respiration. 2005 May-Jun;72(3):233-8
pubmed: 15942290
Eur Respir J. 2005 Nov;26(5):948-68
pubmed: 16264058
Arch Dis Child. 2005 Jul;90(7):737-40
pubmed: 15871981
Chang Gung Med J. 2004 Feb;27(2):122-8
pubmed: 15095957
Indian Pediatr. 2015 Jan;52(1):35-7
pubmed: 25638182
AJR Am J Roentgenol. 1993 Feb;160(2):253-9
pubmed: 8424327
Lancet. 2018 Sep 8;392(10150):866-879
pubmed: 30215382
Pediatr Pulmonol. 2016 May;51(5):450-69
pubmed: 26840008
Arch Dis Child. 1994 Feb;70(2):141-2
pubmed: 8129439
Ir Med J. 2010 Mar;103(3):77-9
pubmed: 20666070
Pediatr Pulmonol. 2018 Dec;53(12):1662-1669
pubmed: 30325109
Respiration. 2009;77(2):160-5
pubmed: 18523381
Pediatr Pulmonol. 2003 Jun;35(6):477-83
pubmed: 12746947