aetiology
Last edited 04/2023 and last reviewed 11/2023
A number of underlying conditions may be responsible for the development of bronchiectasis. In 50% of adults and 25% of children it is idiopathic (1).
Focal bronchiectasis may be caused by:
- Bronchial obstruction – foreign body, broncholith, a slowly growing tumor, anatomic distortion following lobectomy, enlarged lymph node
- severe case of respiratory infection (2).
Diffuse bronchiectasis may be caused by:
- cystic fibrosis
- primary ciliary dyskinesia
- allergic bronchopulmonary aspergillosis (ABPA)
- aspiration or toxic inhalation
- inflammatory disorders - rheumatoid arthritis, inflammatory bowel disease
- decreased host immunity - hypogammaglobulinaemia, HIV infection
- congenital disorders - alpha-1 antitrypsin deficiency, Marfan's syndrome, Young's syndrome (2).
The causes of bronchiectasis may be classified into five main groups:
- defective host defenses
- localised bronchial obstruction
- post-infectious
- inflammatory disorders
- miscellaneous.
British Thoracic Society recommends that the underlying cause of bronchiectasis should be assessed in all patients (3).
Reference:
- ten Hacken NH, van der Molen T. Bronchiectasis. BMJ. 2010 Jul 14;341:c2766. doi: 10.1136/bmj.c2766. PMID: 20630967.
- Rosen MJ. Chronic cough due to bronchiectasis: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):122S-131S
- Pasteur MC et al. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65 Suppl 1:i1-58