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__NOTOC__
__NOTOC__
{{Bronchiectasis}}
{{Bronchiectasis}}
{{CMG}} {{AE}} Saarah T. Alkhairy, M.D.
{{CMG}}; {{AE}} {{HQ}}, Saarah T. Alkhairy, M.D., {{Ochuko}}


==Overview==
==Overview==
Bronchiectasis can be caused by both, congenital and acquired factors. Congenital factors include conditions such as [[Primary ciliary dyskinesia|Kartagener syndrome]] and [[Young's syndrome]]. Acquired factors include [[tuberculosis]] infections such as endobronchial tuberculosis as well as [[inflammatory bowel disease|inflammatory bowel diseases]] like [[Ulcerative Colitis ]] and [[Crohn's disease]].
Bronchiectasis can be caused by both, [[congenital]] and [[acquired]] factors. [[Congenital]] factors include conditions such as [[Primary ciliary dyskinesia|Kartagener syndrome]], [[cystic fibrosis]], [[Young's syndrome]], yellow nail syndrome, [[alpha 1-antitrypsin deficiency]], and primary immunodeficiencies. Acquired factors include post-infectious, [[AIDS]], [[IBD]], [[ABPA]], [[COPD]], [[airway obstructions]], [[ alcohol]], [[drugs]], and [[irritants]].


==Causes==
==Causes==
Bronchiectasis may be either congenital or acquired. Acquired bronchiectasis is more common than congenital bronchiectasis.
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
 
===Commom causes===
*[[Allergic bronchopulmonary aspergillosis]]
*[[Cystic fibrosis]]
*[[Kartagener syndrome]]
*[[Primary ciliary dyskinesia]]
 
===Causes by Organ System===
 
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | [[Immotile cilia syndrome]], [[Kartagener syndrome]], [[Marfan syndrome]], [[primary ciliary dyskinesia]], [[aneurysm|pulmonary artery aneurysm]]
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | [[Ammonia]], [[chlorine gas]], [[irritants]], [[nitrogen dioxide]], [[silicates]], [[talc]]
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | [[Systemic lupus erythematosus]], [[yellow nail syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Drug use]], [[heroin]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | [[Young's syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | [[Bronchiolitis obliterans]], [[smoke]]
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | [[Alpha 1-antitrypsin deficiency]], [[bronchial cyst]], [[Crohn's disease]], [[cystic fibrosis]], [[hiatus hernia]], [[inflammatory bowel disease]], [[irritable bowel syndrome]], [[tracheoesophageal fistula]], [[ulcerative colitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | [[Alpha 1-antitrypsin deficiency]], [[autosomal dominant polycystic kidney disease]], [[Bloom syndrome]], [[chronic granulomatous disease]], [[Crohn's disease]], [[cystic fibrosis]], [[diffuse panbronchiolitis]], [[DiGeorge syndrome]], [[hyper-IgE syndrome]], [[immotile cilia syndrome]], [[Kartagener syndrome]], [[Marfan syndrome]], [[Nezelof syndrome]], [[primary ciliary dyskinesia]], [[severe combined immunodeficiency]], [[WHIM syndrome]], [[X-linked agammaglobulinemia]]
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | [[Immunoglobulin M deficiency]]
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | [[Bone marrow transplantation]], [[heart-lung transplant]], [[lung transplantation]]
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | [[Adenovirus]], [[allergic bronchopulmonary aspergillosis]], [[bordetella pertussis]], [[chronic bronchitis]], [[herpes simplex virus]], [[histoplasmosis]], [[HIV AIDS]], [[immotile cilia syndrome]], [[influenza]], [[Kartagener syndrome]], [[klebsiella ]] , [[laryngeal papillomatosis]], [[measles]], [[mycobacterium avium complex]], [[mycobacterium tuberculosis]], [[mycoplasma pneumoniae]], [[pertussis]], [[pneumonia]], [[primary ciliary dyskinesia]], [[pseudomonas aeruginosa]], [[aspiration pneumonia|recurrent aspiration pneumonia]], [[respiratory syncytial virus]], [[staphylococcus aureus]], [[tuberculosis]], [[whooping cough]]
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | [[Marfan syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | [[Foreign body aspiration]], [[pulmonary aspiration]]
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | [[Alpha 1-antitrypsin deficiency]], [[cystic fibrosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | [[Young's syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | [[adenoma|Airway adenoma]], [[teratoma|endobronchial teratoma]], [[tumor]]
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | [[Marfan syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | [[Drug use]], [[heroin]]
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | [[adenoma|Airway adenoma]], [[airway obstruction]], [[alpha 1-antitrypsin deficiency]], [[bronchial cyst]], [[bronchiolitis obliterans]], [[Bronchocentric Granulomatosis|bronchocentric granulomatosis]], [[bronchomalacia]], [[cartilage deficiency]], [[chronic bronchitis]], [[chronic obstructive pulmonary disease]], [[cystic fibrosis]], [[diffuse panbronchiolitis]], [[bronchus|ectopic bronchus]], [[teratoma|endobronchial teratoma]], [[foreign body aspiration]], [[immotile cilia syndrome]], [[Kartagener syndrome]], [[lipoid pneumonia]], [[Mounier-Kuhn syndrome]], [[pneumonia]], [[primary ciliary dyskinesia]], [[aneurysm|pulmonary artery aneurysm]], [[pulmonary aspiration]], [[aspiration pneumonia|recurrent aspiration pneumonia]], [[sarcoidosis]], [[pulmonary amyloidosis|tracheobronchial amyloidosis]], [[bronchomalacia|tracheobronchomalacia]], [[tracheobronchomegaly]], [[tracheoesophageal fistula]], [[tuberculosis]], [[Williams-Campbell syndrome]], [[yellow nail syndrome]], [[Young's syndrome]]
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | [[Autosomal dominant polycystic kidney disease]], [[systemic lupus erythematosus]]
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | [[Allergies]], [[ankylosing spondylitis]], [[autoimmune diseases]], [[Bruton's agammaglobulinemia]], [[chronic granulomatous disease]], [[common variable immunodeficiency]], [[connective tissue disease]], [[Crohn's disease]], [[DiGeorge syndrome]], [[hyper-IgE syndrome]], [[hypogammaglobulinaemia]], [[immunoglobulin M deficiency]], [[inflammatory bowel disease]], [[MHC class I|MHC class I deficiency]], [[Nezelof syndrome]], [[primary immunodeficiency]], [[relapsing polychondritis]], [[rheumatoid arthritis]], [[sarcoidosis]], [[selective deficiency of immunoglobulin G]], [[selective immunoglobulin A deficiency]], [[severe combined immunodeficiency]], [[Sjögren’s syndrome]], [[systemic lupus erythematosus]], [[ulcerative colitis]], [[WHIM syndrome]], [[x-linked agammaglobulinemia]]
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | [[Alcohol]]
|-
|}
 
===Causes in Alphabetical Order===
{{columns-list|
*[[Adenovirus]]
*[[adenoma|Airway adenoma]]
*[[Airway obstruction]]
*[[Alcohol]]
*[[Allergic bronchopulmonary aspergillosis]]
*[[Allergies]]
*[[Alpha 1-antitrypsin deficiency]]
*[[Ammonia]]
*[[Ankylosing spondylitis]]
*[[Autoimmune diseases]]
*[[Autosomal dominant polycystic kidney disease]]
*[[Bloom syndrome]]
*[[Bone marrow transplantation]]
*[[Bordetella pertussis]]
*[[Bronchial cyst]]
*[[Bronchiolitis obliterans]]
*[[Bronchocentric Granulomatosis|Bronchocentric granulomatosis]]
*[[Bronchomalacia]]
*[[Bruton's agammaglobulinemia]]
*[[Cartilage deficiency]]
*[[Chlorine gas]]
*[[Chronic bronchitis]]
*[[Chronic granulomatous disease]]
*[[Chronic obstructive pulmonary disease]]
*[[Common variable immunodeficiency]]
*[[Connective tissue disease]]
*[[Crohn's disease]]
*[[Cystic fibrosis]]
*[[Diffuse panbronchiolitis]]
*[[DiGeorge syndrome]]
*[[Drug use]]
*[[bronchus|Ectopic bronchus]]
*[[teratoma|Endobronchial teratoma]]
*[[Foreign body aspiration]]
*[[Heart-lung transplant]]
*[[Heroin]]
*[[Herpes simplex virus]]
*[[Hiatus hernia]]
*[[Histoplasmosis]]
*[[HIV AIDS]]
*[[Hyper-IgE syndrome]]
*[[Hypogammaglobulinaemia]]
*[[Immotile cilia syndrome]]
*[[Immunoglobulin M deficiency]]
*[[Inflammatory bowel disease]]
*[[Influenza]]
*[[Irritable bowel syndrome]]
*[[Irritants]]
*[[Kartagener syndrome]]
*[[Klebsiella ]]
*[[Laryngeal papillomatosis]]
*[[Lipoid pneumonia]]
*[[Lung transplantation]]
*[[Marfan syndrome]]
*[[Measles]]
*[[MHC class I|MHC class I deficiency]]
*[[Mounier-Kuhn syndrome]]
*[[Mycobacterium avium complex]]
*[[Mycobacterium tuberculosis]]
*[[Mycoplasma pneumoniae]]
*[[Nezelof syndrome]]
*[[Nitrogen dioxide]]
*[[Pertussis]]
*[[Pneumonia]]
*[[Primary ciliary dyskinesia]]
*[[Primary immunodeficiency]]
*[[Pseudomonas aeruginosa]]
*[[aneurysm|Pulmonary artery aneurysm]]
*[[Pulmonary aspiration]]
*[[aspiration pneumonia|Recurrent aspiration pneumonia]]
*[[Relapsing polychondritis]]
*[[Respiratory syncytial virus]]
*[[Rheumatoid arthritis]]
*[[Sarcoidosis]]
*[[Selective deficiency of immunoglobulin G]]
*[[Selective immunoglobulin A deficiency]]
*[[Severe combined immunodeficiency]]
*[[Silicates]]
*[[Sjögren’s syndrome]]
*[[Smoke]]
*[[Staphylococcus aureus]]
*[[Systemic lupus erythematosus]]
*[[Talc]]
*[[pulmonary amyloidosis|Tracheobronchial amyloidosis]]
*[[bronchomalacia|Tracheobronchomalacia]]
*[[Tracheobronchomegaly]]
*[[Tracheoesophageal fistula]]
*[[Tuberculosis]]
*[[Tumor]]
*[[Ulcerative colitis]]
*[[WHIM syndrome]]
*[[Whooping cough]]
*[[Williams-Campbell syndrome]]
*[[X-linked agammaglobulinemia]]
*[[Yellow nail syndrome]]
*[[Young's syndrome]]
}}
 
===Causes Based on Mode of Infection===
Bronchiectasis may be either [[congenital]] or [[acquired]]. Acquired bronchiectasis is more common than [[Congenital disorder|congenital]] bronchiectasis.
===Congenital===
===Congenital===


The following table lists the congenital causes of bronchiectasis:
The following table lists the [[Congenital disorder|congenital]] causes of bronchiectasis:
{| class="wikitable"
{| class="wikitable"
! '''Causes'''
! '''Causes'''
! '''Description'''
! '''Description'''
|-
|-
| '''Kartagener syndrome'''
| '''[[Primary ciliary dyskinesia|Kartagener syndrome]]'''
| Bronchiectasis is secondary to the impaired mobility of [[cilia]] in the lungs<ref>{{cite journal |author=Morillas HN, Zariwala M, Knowles MR|title=Genetic Causes of Bronchiectasis: Primary Ciliary Dyskinesia |language=English |journal=Respiration |volume=72 |issue=3 |pages=252-63 |year=2007 |pmid=17534128 |doi=}}</ref>
| Bronchiectasis is secondary to the impaired mobility of [[cilia]] in the lungs<ref>{{cite journal |author=Morillas HN, Zariwala M, Knowles MR|title=Genetic Causes of Bronchiectasis: Primary Ciliary Dyskinesia |language=English |journal=Respiration |volume=72 |issue=3 |pages=252-63 |year=2007 |pmid=17534128 |doi=}}</ref>
|-
|-
| '''Cystic fibrosis'''
| [[Cystic fibrosis|'''Cystic fibrosis''' (CF)]]
| A small number of patients develop severe localized bronchiectasis
| A small number of patients develop severe localized bronchiectasis
 
Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary infections<ref>{{cite journal |author=Dalrymple-Hay MJ, Lucas J, Connett G, Lea RE|title=Lung resection for the treatment of severe localized bronchiectasis in cystic fibrosis patients.|language=English |journal=Acta Chir Hung. |volume=38 |issue=1 |pages=23-5 |year=1999 |pmid=10439089 |doi=}}</ref>  
| Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary infections<ref>{{cite journal |author=Dalrymple-Hay MJ, Lucas J, Connett G, Lea RE|title=Lung resection for the treatment of severe localized bronchiectasis in cystic fibrosis patients.|language=English |journal=Acta Chir Hung. |volume=38 |issue=1 |pages=23-5 |year=1999 |pmid=10439089 |doi=}}</ref>  
|-
|-
| '''Young's Syndrome'''
| '''Young's Syndrome'''
| Similar to CF and may be a genetic variant  
| Similar to [[Cystic fibrosis|CF]] and may be a genetic variant  
 
Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary [[Infection|infections]]<ref>{{cite journal |author=Handelsman DJ, Conway AJ, Boylan LM, & Turtle JR |title=Young's syndrome. Obstructive azoospermia and chronic sinopulmonary infections. |language=English |journal=NEJM |volume=310 |issue=1 |pages=3-9 |year=1984 |pmid= |doi=}}</ref>  
| Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary infections<ref>{{cite journal |author=Handelsman DJ, Conway AJ, Boylan LM, & Turtle JR |title=Young's syndrome. Obstructive azoospermia and chronic sinopulmonary infections. |language=English |journal=NEJM |volume=310 |issue=1 |pages=3-9 |year=1984 |pmid= |doi=}}</ref>  
|-
|-
| '''Yellow Nail Syndrome'''
| '''Yellow Nail Syndrome'''
| This is a rare disorder characterized by pleural effusions, lymphedema, and yellow dystrophic nails, chronic bronchitis, sinus infections, and bronchiectasis
| This is a rare disorder characterized by [[pleural effusions]], [[lymphedema]], and yellow dystrophic nails, [[chronic bronchitis]], [[sinus infections]], and bronchiectasis
|-
|-
| '''Alpha 1-Antitrypsin Deficiency'''
| [[Alpha 1-Antitrypsin Deficiency|'''Alpha 1-Antitrypsin Deficiency''' (AAD)]]
| The pathophysiology of development of bronchiectasis among these patients is yet to be understood<ref>{{cite journal |author=Shin MS, Ho KJ |title=Bronchiectasis in patients with alpha 1-antitrypsin deficiency. A rare occurrence?. |language=English |journal=Chest |volume=104 |issue= |pages=1384-86 |year=1993 |pmid= |doi=}}</ref>  
| The pathophysiology of development of bronchiectasis among these patients is yet to be understood<ref>{{cite journal |author=Shin MS, Ho KJ |title=Bronchiectasis in patients with alpha 1-antitrypsin deficiency. A rare occurrence?. |language=English |journal=Chest |volume=104 |issue= |pages=1384-86 |year=1993 |pmid= |doi=}}</ref>  
|-
|-
Line 39: Line 262:


===Acquired===  
===Acquired===  
Acquired bronchiectasis is more common than congenital bronchiectasis. The following table lists the acquired causes of bronchiectasis.
Acquired bronchiectasis is more common than congenital bronchiectasis. The following table lists the [[Acquired disorder|acquired]] causes of bronchiectasis:
{| class="wikitable"
{| class="wikitable"
! '''Causes'''
! '''Causes'''
! '''Description'''
! '''Description'''
|-
|-
| '''Post Infectious''' (viral, bacterial, fungal, atypical mycobacterial)
| '''Post Infectious''' ([[viral]], [[Bacteria|bacterial]], [[Fungus|fungal]], [[Nontuberculous mycobacteria|atypical mycobacterial]])
| Such as [[tuberculosis]] (either from bronchial [[stenosis]] or secondary traction from [[fibrosis]]), [[pneumonia]], [[measles]], [[pertussis]]
| Such as [[tuberculosis]] (either from bronchial [[stenosis]] or secondary traction from [[fibrosis]]), [[pneumonia]], [[measles]], [[pertussis]]
|-
|-
|  '''Acquired Immunodeficiency Syndrome''' (AIDS)
|  [[HIV AIDS|'''Acquired Immunodeficiency Syndrome''' (AIDS)]]
| AIDS is caused by untreated HIV viral infection. Development of bronchiectasis is due to development of opportunistic pulmonary infections<ref>{{cite journal |author=Sheikh S, Madiraju K, Steiner P, Rao M |title=Bronchiectasis in pediatric AIDS.|language=English |journal=Chest |volume=112 |issue=5 |pages=1202-7 |year=1997 |pmid=9367458 |doi=}}</ref>
| [[HIV AIDS|AIDS]] is caused by untreated [[Human Immunodeficiency Virus (HIV)|HIV]] viral infection. Development of bronchiectasis is due to development of opportunistic pulmonary [[Infection|infections]]<ref>{{cite journal |author=Sheikh S, Madiraju K, Steiner P, Rao M |title=Bronchiectasis in pediatric AIDS.|language=English |journal=Chest |volume=112 |issue=5 |pages=1202-7 |year=1997 |pmid=9367458 |doi=}}</ref>
|-
|-
| '''Inflammatory Bowel Disease'''
| [[Inflammatory Bowel Disease|'''Inflammatory Bowel Disease''' (IBD)]]
| The exact pathogenesis is unknown for the link between inflammatory bowel disease and bronchiectasis
| The exact pathogenesis is unknown for the link between [[inflammatory bowel disease]] and bronchiectasis
Bronchiectasis is more common among patients with [[ulcerative colitis]] than those with Crohn's disease
Bronchiectasis is more common among patients with [[ulcerative colitis]] than those with Crohn's disease
|-
|-
| '''Allergic Bronchopulmonary Aspergillosis''' (ABPA)
| [[Aspergillosis|'''Allergic Bronchopulmonary Aspergillosis''' (ABPA)]]
| Development of bronchiectasis is associated with inhalation of [[fungus]] spores<ref>{{cite journal |author=Ferguson HR, Convery RP |title=An unusual complication of ulcerative colitis |language=English |journal=Postgrad. Med. J. |volume=78 |issue= |pages=503 |year=2002 |pmid= |doi=}}</ref>
| Development of bronchiectasis is associated with inhalation of [[fungus]] spores<ref>{{cite journal |author=Ferguson HR, Convery RP |title=An unusual complication of ulcerative colitis |language=English |journal=Postgrad. Med. J. |volume=78 |issue= |pages=503 |year=2002 |pmid= |doi=}}</ref>
|-
|-
| Connective Tissue Diseases such as ''' Rheumatoid arthritis'''
| '''Connective Tissue Diseases''' such as Rheumatoid arthritis  
| Patterns of lung injury are common in connective tissue disease - which eventually leads to bronchiectasis
| Patterns of lung injury are common in connective tissue disease - which eventually leads to bronchiectasis
|-
|-
| '''Airway obstructions'''
| '''Airway obstructions'''
| Such as tumors or enlarged lymph nodes
| Such as [[tumors]] or enlarged [[lymph nodes]]
These obstructions can block the airways leading to bronchiectasis
These obstructions can block the airways leading to bronchiectasis
|-
|-
| '''Chronic Obstructive Pulmonary Disease''' (COPD)
| [[Chronic obstructive pulmonary disease|'''Chronic Obstructive Pulmonary Disease''' (COPD)]]
| The mucus build up from COPD can lead to bronchiectasis
| The [[mucus]] build up from [[COPD]] can lead to bronchiectasis
|-
|-
| '''Environmental exposures''' such as ammonia
| '''Environmental exposures''' such as ammonia
| The environmental irritants cause inflammation in the airways that can lead to bronchiectasis
| The environmental [[irritants]] cause [[inflammation]] in the airways that can lead to bronchiectasis
|-
|-
|  ''' Alcoholism'''  
|  ''' [[Alcoholism]]'''  
| Heavy drinking causes a deficiency of the antioxidant glutathione in the lungs, which increases the susceptibility of various lung diseases including bronchiectasis
| Heavy drinking causes a deficiency of the antioxidant [[glutathione]] in the lungs, which increases the susceptibility of various lung diseases including bronchiectasis
|-
|-
| '''Drug use''' such as heroin
| '''Drug use''' such as heroin
|  
| Various drugs cause [[inflammation]] in the airways that can lead to bronchiectasis
|-
|-
| '''Various allergies'''
| '''Various allergies'''
| Allergies cause inflammation in the airways that can lead to bronchiectasis<ref>{{cite journal |author=Lamari NM, Martins ALQ, Oliveira JV, Marino LC, Valério N |title=Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion.|language=Portuguese |journal=Braz. j. cardiovasc. surg. |volume=21 |issue=2 |pages= |year=2006 |pmid= |doi=}}</ref>
| Allergies cause [[inflammation]] in the airways that can lead to bronchiectasis<ref>{{cite journal |author=Lamari NM, Martins ALQ, Oliveira JV, Marino LC, Valério N |title=Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion.|language=Portuguese |journal=Braz. j. cardiovasc. surg. |volume=21 |issue=2 |pages= |year=2006 |pmid= |doi=}}</ref>
|
|}
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 20:43, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Saarah T. Alkhairy, M.D., Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Bronchiectasis can be caused by both, congenital and acquired factors. Congenital factors include conditions such as Kartagener syndrome, cystic fibrosis, Young's syndrome, yellow nail syndrome, alpha 1-antitrypsin deficiency, and primary immunodeficiencies. Acquired factors include post-infectious, AIDS, IBD, ABPA, COPD, airway obstructions, alcohol, drugs, and irritants.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Commom causes

Causes by Organ System

Cardiovascular Immotile cilia syndrome, Kartagener syndrome, Marfan syndrome, primary ciliary dyskinesia, pulmonary artery aneurysm
Chemical/Poisoning Ammonia, chlorine gas, irritants, nitrogen dioxide, silicates, talc
Dental No underlying causes
Dermatologic Systemic lupus erythematosus, yellow nail syndrome
Drug Side Effect Drug use, heroin
Ear Nose Throat Young's syndrome
Endocrine No underlying causes
Environmental Bronchiolitis obliterans, smoke
Gastroenterologic Alpha 1-antitrypsin deficiency, bronchial cyst, Crohn's disease, cystic fibrosis, hiatus hernia, inflammatory bowel disease, irritable bowel syndrome, tracheoesophageal fistula, ulcerative colitis
Genetic Alpha 1-antitrypsin deficiency, autosomal dominant polycystic kidney disease, Bloom syndrome, chronic granulomatous disease, Crohn's disease, cystic fibrosis, diffuse panbronchiolitis, DiGeorge syndrome, hyper-IgE syndrome, immotile cilia syndrome, Kartagener syndrome, Marfan syndrome, Nezelof syndrome, primary ciliary dyskinesia, severe combined immunodeficiency, WHIM syndrome, X-linked agammaglobulinemia
Hematologic Immunoglobulin M deficiency
Iatrogenic Bone marrow transplantation, heart-lung transplant, lung transplantation
Infectious Disease Adenovirus, allergic bronchopulmonary aspergillosis, bordetella pertussis, chronic bronchitis, herpes simplex virus, histoplasmosis, HIV AIDS, immotile cilia syndrome, influenza, Kartagener syndrome, klebsiella , laryngeal papillomatosis, measles, mycobacterium avium complex, mycobacterium tuberculosis, mycoplasma pneumoniae, pertussis, pneumonia, primary ciliary dyskinesia, pseudomonas aeruginosa, recurrent aspiration pneumonia, respiratory syncytial virus, staphylococcus aureus, tuberculosis, whooping cough
Musculoskeletal/Orthopedic Marfan syndrome
Neurologic Foreign body aspiration, pulmonary aspiration
Nutritional/Metabolic Alpha 1-antitrypsin deficiency, cystic fibrosis
Obstetric/Gynecologic Young's syndrome
Oncologic Airway adenoma, endobronchial teratoma, tumor
Ophthalmologic Marfan syndrome
Overdose/Toxicity No underlying causes
Psychiatric Drug use, heroin
Pulmonary Airway adenoma, airway obstruction, alpha 1-antitrypsin deficiency, bronchial cyst, bronchiolitis obliterans, bronchocentric granulomatosis, bronchomalacia, cartilage deficiency, chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, diffuse panbronchiolitis, ectopic bronchus, endobronchial teratoma, foreign body aspiration, immotile cilia syndrome, Kartagener syndrome, lipoid pneumonia, Mounier-Kuhn syndrome, pneumonia, primary ciliary dyskinesia, pulmonary artery aneurysm, pulmonary aspiration, recurrent aspiration pneumonia, sarcoidosis, tracheobronchial amyloidosis, tracheobronchomalacia, tracheobronchomegaly, tracheoesophageal fistula, tuberculosis, Williams-Campbell syndrome, yellow nail syndrome, Young's syndrome
Renal/Electrolyte Autosomal dominant polycystic kidney disease, systemic lupus erythematosus
Rheumatology/Immunology/Allergy Allergies, ankylosing spondylitis, autoimmune diseases, Bruton's agammaglobulinemia, chronic granulomatous disease, common variable immunodeficiency, connective tissue disease, Crohn's disease, DiGeorge syndrome, hyper-IgE syndrome, hypogammaglobulinaemia, immunoglobulin M deficiency, inflammatory bowel disease, MHC class I deficiency, Nezelof syndrome, primary immunodeficiency, relapsing polychondritis, rheumatoid arthritis, sarcoidosis, selective deficiency of immunoglobulin G, selective immunoglobulin A deficiency, severe combined immunodeficiency, Sjögren’s syndrome, systemic lupus erythematosus, ulcerative colitis, WHIM syndrome, x-linked agammaglobulinemia
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Alcohol

Causes in Alphabetical Order

Causes Based on Mode of Infection

Bronchiectasis may be either congenital or acquired. Acquired bronchiectasis is more common than congenital bronchiectasis.

Congenital

The following table lists the congenital causes of bronchiectasis:

Causes Description
Kartagener syndrome Bronchiectasis is secondary to the impaired mobility of cilia in the lungs[1]
Cystic fibrosis (CF) A small number of patients develop severe localized bronchiectasis

Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary infections[2]

Young's Syndrome Similar to CF and may be a genetic variant

Development of bronchiectasis is mainly due to the increased risk of chronic sinopulmonary infections[3]

Yellow Nail Syndrome This is a rare disorder characterized by pleural effusions, lymphedema, and yellow dystrophic nails, chronic bronchitis, sinus infections, and bronchiectasis
Alpha 1-Antitrypsin Deficiency (AAD) The pathophysiology of development of bronchiectasis among these patients is yet to be understood[4]
Primary Immunodeficiencies Bronchiectasis is caused by the weakened immune system's response to severe, recurrent pulmonary infections[5]

Acquired

Acquired bronchiectasis is more common than congenital bronchiectasis. The following table lists the acquired causes of bronchiectasis:

Causes Description
Post Infectious (viral, bacterial, fungal, atypical mycobacterial) Such as tuberculosis (either from bronchial stenosis or secondary traction from fibrosis), pneumonia, measles, pertussis
Acquired Immunodeficiency Syndrome (AIDS) AIDS is caused by untreated HIV viral infection. Development of bronchiectasis is due to development of opportunistic pulmonary infections[6]
Inflammatory Bowel Disease (IBD) The exact pathogenesis is unknown for the link between inflammatory bowel disease and bronchiectasis

Bronchiectasis is more common among patients with ulcerative colitis than those with Crohn's disease

Allergic Bronchopulmonary Aspergillosis (ABPA) Development of bronchiectasis is associated with inhalation of fungus spores[7]
Connective Tissue Diseases such as Rheumatoid arthritis Patterns of lung injury are common in connective tissue disease - which eventually leads to bronchiectasis
Airway obstructions Such as tumors or enlarged lymph nodes

These obstructions can block the airways leading to bronchiectasis

Chronic Obstructive Pulmonary Disease (COPD) The mucus build up from COPD can lead to bronchiectasis
Environmental exposures such as ammonia The environmental irritants cause inflammation in the airways that can lead to bronchiectasis
Alcoholism Heavy drinking causes a deficiency of the antioxidant glutathione in the lungs, which increases the susceptibility of various lung diseases including bronchiectasis
Drug use such as heroin Various drugs cause inflammation in the airways that can lead to bronchiectasis
Various allergies Allergies cause inflammation in the airways that can lead to bronchiectasis[8]

References

  1. ↑ Morillas HN, Zariwala M, Knowles MR (2007). "Genetic Causes of Bronchiectasis: Primary Ciliary Dyskinesia". Respiration. 72 (3): 252–63. PMID 17534128.
  2. ↑ Dalrymple-Hay MJ, Lucas J, Connett G, Lea RE (1999). "Lung resection for the treatment of severe localized bronchiectasis in cystic fibrosis patients". Acta Chir Hung. 38 (1): 23–5. PMID 10439089.
  3. ↑ Handelsman DJ, Conway AJ, Boylan LM, & Turtle JR (1984). "Young's syndrome. Obstructive azoospermia and chronic sinopulmonary infections". NEJM. 310 (1): 3–9.
  4. ↑ Shin MS, Ho KJ (1993). "Bronchiectasis in patients with alpha 1-antitrypsin deficiency. A rare occurrence?". Chest. 104: 1384–86.
  5. ↑ Notarangelo LD, Plebani A, Mazzolari E, Soresina A, Bondioni MP (2007). "Genetic causes of bronchiectasis: primary immune deficiencies and the lung". Respiration. 74 (3): 264–75. PMID 17534129.
  6. ↑ Sheikh S, Madiraju K, Steiner P, Rao M (1997). "Bronchiectasis in pediatric AIDS". Chest. 112 (5): 1202–7. PMID 9367458.
  7. ↑ Ferguson HR, Convery RP (2002). "An unusual complication of ulcerative colitis". Postgrad. Med. J. 78: 503.
  8. ↑ Lamari NM, Martins ALQ, Oliveira JV, Marino LC, Valério N (2006). "Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion". Braz. j. cardiovasc. surg. (in Portuguese). 21 (2).

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