Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2020

01-12-2020 | Bronchiectasis | Research article

Changing clinical characteristics of non-cystic fibrosis bronchiectasis in children

Authors: Ela Erdem Eralp, Yasemin Gokdemir, Emine Atag, Nilay Bas Ikizoglu, Pinar Ergenekon, Cansu Yilmaz Yegit, Arif Kut, Refika Ersu, Fazilet Karakoc, Bulent Karadag

Published in: BMC Pulmonary Medicine | Issue 1/2020

Login to get access

Abstract

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

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

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

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.
Literature
1.
go back to reference Chang AB, Bush A, Grimwood K. Bronchiectasis in children: diagnosis and treatment. Lancet. 2018;392(10150):866–79.CrossRef Chang AB, Bush A, Grimwood K. Bronchiectasis in children: diagnosis and treatment. Lancet. 2018;392(10150):866–79.CrossRef
2.
go back to reference Goyal V, Grimwood K, Marchant J, Masters IB, Chang AB. Pediatric bronchiectasis: no longer an orphan disease. Pediatr Pulmonol. 2016;51:450–69.CrossRef Goyal V, Grimwood K, Marchant J, Masters IB, Chang AB. Pediatric bronchiectasis: no longer an orphan disease. Pediatr Pulmonol. 2016;51:450–69.CrossRef
3.
go back to reference McCallum GB, Binks MJ. The epidemiology of chronic suppurative lung disease and bronchiectasis in children and adolescents. Front Pediatr. 2017;5:27.PubMedPubMedCentral McCallum GB, Binks MJ. The epidemiology of chronic suppurative lung disease and bronchiectasis in children and adolescents. Front Pediatr. 2017;5:27.PubMedPubMedCentral
4.
go back to reference Twiss J, Metcalfe R, Edwards E, Byrnes C. New Zealand national incidence of 2005 bronchiectasis "too high" for a developed country. Arch Dis Child. 2005;90:737–40.CrossRef Twiss J, Metcalfe R, Edwards E, Byrnes C. New Zealand national incidence of 2005 bronchiectasis "too high" for a developed country. Arch Dis Child. 2005;90:737–40.CrossRef
5.
go back to reference Brower KS, Del Vecchio MT, Aronoff SC. The etiologies of non-CF bronchiectasis in childhood: a systematic review of 989 subjects. BMC Pediatr. 2014;14:4.CrossRef Brower KS, Del Vecchio MT, Aronoff SC. The etiologies of non-CF bronchiectasis in childhood: a systematic review of 989 subjects. BMC Pediatr. 2014;14:4.CrossRef
6.
go back to reference Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo PJ. Non-CF bronchiectasis: clinical and HRCT evaluation. Pediatr Pulmonol. 2003;35:477–83.CrossRef Chang AB, Masel JP, Boyce NC, Wheaton G, Torzillo PJ. Non-CF bronchiectasis: clinical and HRCT evaluation. Pediatr Pulmonol. 2003;35:477–83.CrossRef
7.
go back to reference Singleton RJ, Morris A, Redding A, Poll J, Holck P, Martinez P, Kruse D, Bulkow LR, Petersen KM, Lewis C. Bronchiectasis in Alaska native children:cases and clinical courses. Pediatr Pulmonol. 2000;29:182–7.CrossRef Singleton RJ, Morris A, Redding A, Poll J, Holck P, Martinez P, Kruse D, Bulkow LR, Petersen KM, Lewis C. Bronchiectasis in Alaska native children:cases and clinical courses. Pediatr Pulmonol. 2000;29:182–7.CrossRef
8.
go back to reference Zaid AA, Elnazir B, Greally P. A decade of non-cystic fibrosis bronchiectasis 1996-2006. Ir Med J. 2010;103:77–9.PubMed Zaid AA, Elnazir B, Greally P. A decade of non-cystic fibrosis bronchiectasis 1996-2006. Ir Med J. 2010;103:77–9.PubMed
9.
go back to reference Kapur N, Grimwood K, Masters IB, Morris PS, Chang AB. Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis. Pediatr Pulmonol. 2012;47:300–7.CrossRef Kapur N, Grimwood K, Masters IB, Morris PS, Chang AB. Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis. Pediatr Pulmonol. 2012;47:300–7.CrossRef
10.
go back to reference Santamaria F, Montella S, Pifferi M, Ragazzo V, De Stefano S, De Paulis N, Maglione M, Boner AL. A descriptive study of non-cystic fibrosis bronchiectasis in a pediatric population from central and southern Italy. Respiration. 2009;77:160–5.CrossRef Santamaria F, Montella S, Pifferi M, Ragazzo V, De Stefano S, De Paulis N, Maglione M, Boner AL. A descriptive study of non-cystic fibrosis bronchiectasis in a pediatric population from central and southern Italy. Respiration. 2009;77:160–5.CrossRef
11.
go back to reference Nikolaizik WH, Warner JO. Aetiology of chronic suppurative lung disease. Arch Dis Child. 1994;70:141–2.CrossRef Nikolaizik WH, Warner JO. Aetiology of chronic suppurative lung disease. Arch Dis Child. 1994;70:141–2.CrossRef
12.
go back to reference Li AM, Sonnappa S, Lex C, Wong E, Zacharasiewicz A, Bush A, Jaffe A. Non-CF bronchiectasis: does knowing the aetiology lead to changes in management? Eur Respir J. 2005;26:8–14.CrossRef Li AM, Sonnappa S, Lex C, Wong E, Zacharasiewicz A, Bush A, Jaffe A. Non-CF bronchiectasis: does knowing the aetiology lead to changes in management? Eur Respir J. 2005;26:8–14.CrossRef
13.
go back to reference Eastham KM, Fall AJ, Mitchell L, Spencer DA. The need to redefine non-cystic fibrosis bronchiectasis in childhood. Thorax. 2004;59:324–7.CrossRef Eastham KM, Fall AJ, Mitchell L, Spencer DA. The need to redefine non-cystic fibrosis bronchiectasis in childhood. Thorax. 2004;59:324–7.CrossRef
14.
go back to reference Kumar A, Lodha R, Kumar P, Kabra SK. Non-cystic fibrosis bronchiectasis in children: clinical profile, etiology and outcome. Indian Pediatr. 2015;52:35–7.CrossRef Kumar A, Lodha R, Kumar P, Kabra SK. Non-cystic fibrosis bronchiectasis in children: clinical profile, etiology and outcome. Indian Pediatr. 2015;52:35–7.CrossRef
15.
go back to reference Quint JK, Millett ER, Joshi M, Navaratnam V, Thomas SL, Hurst JR, Smeeth L, Brown JS. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study. Eur Respir J. 2016;47:186–93.CrossRef Quint JK, Millett ER, Joshi M, Navaratnam V, Thomas SL, Hurst JR, Smeeth L, Brown JS. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study. Eur Respir J. 2016;47:186–93.CrossRef
16.
go back to reference Diel R, Ewig S, Blaas S, Jacob C, Juelich F, Korfmann G, Sohrab S, Sutharsan S, Rademacher J. Incidence of patients with non-cystic fibrosis bronchiectasis in Germany-a healthcare insurance claims data analysis. Respir Med. 2019;151:121–7.CrossRef Diel R, Ewig S, Blaas S, Jacob C, Juelich F, Korfmann G, Sohrab S, Sutharsan S, Rademacher J. Incidence of patients with non-cystic fibrosis bronchiectasis in Germany-a healthcare insurance claims data analysis. Respir Med. 2019;151:121–7.CrossRef
17.
go back to reference Karadag B, Karakoc F, Ersu R, Kut A, Bakac S, Dagli E. Non-cystic-fibrosis bronchiectasis in children: a persisting problem in developing countries. Respiration. 2005;72:233–8.CrossRef Karadag B, Karakoc F, Ersu R, Kut A, Bakac S, Dagli E. Non-cystic-fibrosis bronchiectasis in children: a persisting problem in developing countries. Respiration. 2005;72:233–8.CrossRef
18.
go back to reference Chang AB, Bell SC, Torzillo PJ, King PT, Maguire GP, Byrnes CA, Holland AE, O'Mara P, Grimwood K, extended voting group. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and new Zealand Thoracic Society of Australia and new Zealand guidelines. Med J Aust. 2015;202:21–3.CrossRef Chang AB, Bell SC, Torzillo PJ, King PT, Maguire GP, Byrnes CA, Holland AE, O'Mara P, Grimwood K, extended voting group. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and new Zealand Thoracic Society of Australia and new Zealand guidelines. Med J Aust. 2015;202:21–3.CrossRef
19.
go back to reference McGuinness G, Naidich DP, Leitman BS, McCauley DI. Bronchiectasis: CT evaluation. Am J Roentgenol. 1993;160:253–9.CrossRef McGuinness G, Naidich DP, Leitman BS, McCauley DI. Bronchiectasis: CT evaluation. Am J Roentgenol. 1993;160:253–9.CrossRef
20.
go back to reference Kapur N, Masters IB, Morris PS, Galligan J, Ware R, Chang AB. Defining pulmonary exacerbation in children with non-cystic fibrosis bronchiectasis. Pediatr Pulmonol. 2012;47:68–75.CrossRef Kapur N, Masters IB, Morris PS, Galligan J, Ware R, Chang AB. Defining pulmonary exacerbation in children with non-cystic fibrosis bronchiectasis. Pediatr Pulmonol. 2012;47:68–75.CrossRef
21.
go back to reference Valery PC, Morris PS, Byrnes CA, et al. Long-term azithromycin for indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (bronchiectasis intervention study): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2013;1:610–20.CrossRef Valery PC, Morris PS, Byrnes CA, et al. Long-term azithromycin for indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (bronchiectasis intervention study): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2013;1:610–20.CrossRef
22.
go back to reference Leigh MW, Hazucha MJ, Chawla KK, Baker BR, Shapiro AJ, Brown DE, Lavange LM, Horton BJ, Qaqish B, Carson JL, et al. Standardizing nasal nitric oxide measurement as a test for primary ciliary dyskinesia. Ann Am Thorac Soc. 2013;10:574–81.CrossRef Leigh MW, Hazucha MJ, Chawla KK, Baker BR, Shapiro AJ, Brown DE, Lavange LM, Horton BJ, Qaqish B, Carson JL, et al. Standardizing nasal nitric oxide measurement as a test for primary ciliary dyskinesia. Ann Am Thorac Soc. 2013;10:574–81.CrossRef
23.
go back to reference Global Initiative for Asthma. GINA report, global strategy for asthma management and prevention. Revised 2019. Available at: www.ginasthma.org. Global Initiative for Asthma. GINA report, global strategy for asthma management and prevention. Revised 2019. Available at: www.​ginasthma.​org.
24.
go back to reference Poglar G, Promadhat V. Pulmonary function testing in children: techniques and standards. Philadelphia: Saunders; 1971. Poglar G, Promadhat V. Pulmonary function testing in children: techniques and standards. Philadelphia: Saunders; 1971.
25.
go back to reference Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, Van der Grinten CP, Gustafsson P, Hankinson J, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948–68.CrossRef Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, Van der Grinten CP, Gustafsson P, Hankinson J, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948–68.CrossRef
26.
go back to reference Atag E, Hjeij R, Ikizoğlu NB, Ergenekon P, Yegit CY, Gokdemir Y, et al. Immunofluorescense staining results in respiratory epithelial cells of patients with suspected PCD from Marmara University. ERJ. 2019;54(Suppl 63):PA386. Atag E, Hjeij R, Ikizoğlu NB, Ergenekon P, Yegit CY, Gokdemir Y, et al. Immunofluorescense staining results in respiratory epithelial cells of patients with suspected PCD from Marmara University. ERJ. 2019;54(Suppl 63):PA386.
27.
go back to reference Karakoc GB, Yilmaz M, Altintas DU, Kendirli SG. Bronchiectasis: still a problem. Pediatr Pulmonol. 2001;32:175–8.CrossRef Karakoc GB, Yilmaz M, Altintas DU, Kendirli SG. Bronchiectasis: still a problem. Pediatr Pulmonol. 2001;32:175–8.CrossRef
28.
go back to reference Bahçeci S, Karaman S, Nacaroğlu HT, Yazıcı S, Girit S, Ünsal-Karkıner Ş, Can D. Changing epidemiology of non-cystic fibrosis bronchiectasis. Turk J Pediatr. 2016;58:19–26.CrossRef Bahçeci S, Karaman S, Nacaroğlu HT, Yazıcı S, Girit S, Ünsal-Karkıner Ş, Can D. Changing epidemiology of non-cystic fibrosis bronchiectasis. Turk J Pediatr. 2016;58:19–26.CrossRef
29.
go back to reference Satırer O, Mete Yesil A, Emiralioglu N, Tugcu GD, Yalcın E, Dogru D, Kiper N, Ozcelik U. A review of the etiology and clinical presentation of non-cystic fibrosis bronchiectasis: a tertiary care experience. Respir Med. 2018;137:35–9.CrossRef Satırer O, Mete Yesil A, Emiralioglu N, Tugcu GD, Yalcın E, Dogru D, Kiper N, Ozcelik U. A review of the etiology and clinical presentation of non-cystic fibrosis bronchiectasis: a tertiary care experience. Respir Med. 2018;137:35–9.CrossRef
30.
go back to reference Munro KA, Reed PW, Joyce H, Perry D, Twiss J, Byrnes CA, Edwards EA. Do New Zealand children with non-cystic fibrosis bronchiectasis show disease progression? Pediatr Pulmonol. 2011;46:131–8.CrossRef Munro KA, Reed PW, Joyce H, Perry D, Twiss J, Byrnes CA, Edwards EA. Do New Zealand children with non-cystic fibrosis bronchiectasis show disease progression? Pediatr Pulmonol. 2011;46:131–8.CrossRef
31.
go back to reference Kapur N, Karadag B. Differences and similarities in non-cystic fibrosis bronchiectasis between developing and affluent countries. Paediatr Respir Rev. 2011;12:91–6.CrossRef Kapur N, Karadag B. Differences and similarities in non-cystic fibrosis bronchiectasis between developing and affluent countries. Paediatr Respir Rev. 2011;12:91–6.CrossRef
32.
go back to reference Kapur N, Masters IB, Chang AB. Longitudinal growth and lung function in pediatric non-CF bronchiectasis-what influences lung function stability? Chest. 2010;138:158–64.CrossRef Kapur N, Masters IB, Chang AB. Longitudinal growth and lung function in pediatric non-CF bronchiectasis-what influences lung function stability? Chest. 2010;138:158–64.CrossRef
33.
go back to reference Bastardo CM, Sonnappa S, Stanojevic S, Navarro A, Lopez PM, Jaffe A, Bush A. Non-cystic fibrosis bronchiectasis in childhood: longitudinal growth and lung function. Thorax. 2009;64:246–51.CrossRef Bastardo CM, Sonnappa S, Stanojevic S, Navarro A, Lopez PM, Jaffe A, Bush A. Non-cystic fibrosis bronchiectasis in childhood: longitudinal growth and lung function. Thorax. 2009;64:246–51.CrossRef
34.
go back to reference Halbeisen FS, Goutaki M, Spycher BD, Amirav I, Behan L, Boon M, et al. Lung function in patients with Primary Ciliary Dyskinesia: an iPCD Cohort study. Eur Respir J. 2018;52(2):1801040.CrossRef Halbeisen FS, Goutaki M, Spycher BD, Amirav I, Behan L, Boon M, et al. Lung function in patients with Primary Ciliary Dyskinesia: an iPCD Cohort study. Eur Respir J. 2018;52(2):1801040.CrossRef
35.
go back to reference Kinghorn B, Singleton R, McCallum GB, Bulkow L, Grimwood K, Hermann L, Chang AB, Redding G. Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska native children. Pediatr Pulmonol. 2018;53:1662–9.CrossRef Kinghorn B, Singleton R, McCallum GB, Bulkow L, Grimwood K, Hermann L, Chang AB, Redding G. Clinical course of chronic suppurative lung disease and bronchiectasis in Alaska native children. Pediatr Pulmonol. 2018;53:1662–9.CrossRef
36.
go back to reference Banjar HH. Clinical profile of Saudi children with bronchiectasis. Indian J Pediatr. 2007;74:149–52.CrossRef Banjar HH. Clinical profile of Saudi children with bronchiectasis. Indian J Pediatr. 2007;74:149–52.CrossRef
37.
go back to reference Edwards EA, Metcalfe R, Milne DG, Thompson J, Byrnes CA. Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. Pediatr Pulmonol. 2003;36:87–93.CrossRef Edwards EA, Metcalfe R, Milne DG, Thompson J, Byrnes CA. Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. Pediatr Pulmonol. 2003;36:87–93.CrossRef
38.
go back to reference Kapur N, Masters IB, Chang AB. Exacerbations in noncystic fibrosis bronchiectasis: clinical features and investigations. Respir Med. 2009;103:1681–7.CrossRef Kapur N, Masters IB, Chang AB. Exacerbations in noncystic fibrosis bronchiectasis: clinical features and investigations. Respir Med. 2009;103:1681–7.CrossRef
39.
go back to reference Lai SH, Wong KS, Liao SL. Clinical analysis of bronchiectasis in Taiwanese children. Chang Gung Med J. 2004;27:122–8.PubMed Lai SH, Wong KS, Liao SL. Clinical analysis of bronchiectasis in Taiwanese children. Chang Gung Med J. 2004;27:122–8.PubMed
40.
go back to reference Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65(Suppl. 1):i1–58.CrossRef Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65(Suppl. 1):i1–58.CrossRef
41.
go back to reference Pizzutto SJ, Hare KM, Upham JW. Bronchiectasis in children: current concepts in immunology and microbiology. Front Pediatr. 2017;5:123.CrossRef Pizzutto SJ, Hare KM, Upham JW. Bronchiectasis in children: current concepts in immunology and microbiology. Front Pediatr. 2017;5:123.CrossRef
Metadata
Title
Changing clinical characteristics of non-cystic fibrosis bronchiectasis in children
Authors
Ela Erdem Eralp
Yasemin Gokdemir
Emine Atag
Nilay Bas Ikizoglu
Pinar Ergenekon
Cansu Yilmaz Yegit
Arif Kut
Refika Ersu
Fazilet Karakoc
Bulent Karadag
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2020
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-020-01214-7

Other articles of this Issue 1/2020

BMC Pulmonary Medicine 1/2020 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.