Causes of bronchiectasis in children
- Khoulood Fakhoury, MD
Khoulood Fakhoury, MD
- Assistant Professor of Pediatrics
- Baylor College of Medicine
- Adaobi Kanu, MD
Adaobi Kanu, MD
- Associate Professor of Pediatrics
- Texas Tech Health Sciences Center
Bronchiectasis is a structural abnormality characterized by abnormal dilation and distortion of the bronchial tree, resulting in chronic obstructive lung disease. This condition is typically the end result of a variety of pathophysiologic processes that render the bronchial walls weakened, easily collapsible, chronically inflamed, and plugged with mucus secretions.
In resource-rich countries, cystic fibrosis (CF) is the most common cause of bronchiectasis in children. The evaluation and management of CF-related bronchiectasis is discussed in detail in separate topic reviews. (See "Cystic fibrosis: Clinical manifestations and diagnosis" and "Cystic fibrosis: Clinical manifestations of pulmonary disease" and "Cystic fibrosis: Overview of the treatment of lung disease" and "Cystic fibrosis: Antibiotic therapy for chronic pulmonary infection".)
Bronchiectasis can be caused by a variety of disease processes other than CF, most of which include some combination of bronchial obstruction and infection. The types of disorders that cause bronchiectasis vary among populations and age groups. As examples, infections and acquired causes of bronchiectasis predominate in adults and in resource-limited countries, whereas congenital anomalies of the airways or immune system are more prominent in children and resource-rich countries.
This topic review will outline the pathogenesis and main causes of non-CF related bronchiectasis in children. The evaluation and management of non-CF bronchiectasis in children, and the causes of bronchiectasis in adults are discussed in separate topic reviews. (See "Clinical manifestations and evaluation of bronchiectasis in children" and "Management of bronchiectasis in children without cystic fibrosis" and "Clinical manifestations and diagnosis of bronchiectasis in adults".)
Prevalence rates vary substantially depending on the method used for case identification. Use of high-resolution computed tomography (CT) will detect milder disease, and result in higher prevalence estimates than strategies employing less sensitive forms of radiography.
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