Bronchiectasis laboratory findings

Bronchiectasis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Bronchiectasis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Bronchiectasis laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Bronchiectasis laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Bronchiectasis laboratory findings
CDC on Bronchiectasis laboratory findings
Bronchiectasis laboratory findings in the news
Blogs on Bronchiectasis laboratory findings
Directions to Hospitals Treating Bronchiectasis
Risk calculators and risk factors for Bronchiectasis laboratory findings

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

Overview

There are both routine investigations and special case investigations. Routine investigations include sputum analysis, full blood count, and quantitative immunoglobulin levels. Cystic fibrosis and autoimmune testing are done if the patient is suspected of having an underlying condition.

Bronchiectasis Laboratory Findings

Sputum Analysis

• Observe for Dittrich plugs (foul smelling masses of bacteria), white or yellow concretions
• A gram stain and culture should be performed

• Evidence of Pseudomonas aeruginosa, Escherichia coli, or Staphylococcus aureus may suggest cystic fibrosis (CF) or allergic bronchopulmonary aspergillosis (ABPA)

• A smear and culture should be performed for Mycobacterium and fungi
• Sputum acid fast bacilli for tuberculosis

Full Blood Count

• Anemia
• Polycythemia (secondary to hypoxia) in severe cases
• Leukocytosis
• Neutrophilia
• Eosinophilia suggests bronchopulmonary aspergillosis (ABPA).

Quantitative Immunoglobulin Levels

• Measure IgG, IgA, IgM, and serum electrophoresis to exclude hypogammaglobulinemia
• Serum IgE or skin prick testing or IgE radioallergosorbent test for ABPA

• Diagnostic criteria include a total serum IgE level greater than 1000 IU/mL or a greater than 2-fold rise from baseline

• Antibodies to Haemophilus influenza type B or Streptococcus pneumonia

Quantitative Serum Alpha 1-antitrypsin (AAT) Levels

• This is used to rule out AAT deficiency

Tests for Ciliary Function

• Screening for PCD-nasal nitric oxide measurements, nasal biopsy and ciliary beat frequency
• Screening should be done if there is childhood chronic otitis media, infertility, dextrocardia, or middle lobe bronchiectasis

Testing for Cystic Fibrosis

• Two measurements of sweat chloride and cystic fibrosis transmembrane regulator (CFTR) genetic mutation analysis should be done for all children and adults up to 40 years
• If the the patient is more than 40 years, he should do cystic fibrosis testing if he has persistent isolation of Staphylococcus aureus in the sputum, features of malabsorption, male primary infertility, upper lobe bronchiectasis, or a history of childhood steatorrhoea

24-hour pH Monitoring

• This testing is for those who are suspected of having bronchiectasis secondary to gastrointestinal reflux or aspiration.\

Autoimmune Screening Tests

• These test should be done if the patient is suspected of having an autoimmune disorder such as Rheumatoid Arthritis