Bronchiectasis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

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 APBD, 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

• Allergic bronchopulmonary aspergillosis
• Cystic fibrosis
• Kartagener syndrome
• Primary ciliary dyskinesia

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

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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
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
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
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
Primary Immunodeficiencies	Bronchiectasis is caused by the weakened immune system's response to severe, recurrent pulmonary infections

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
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
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