Bronchiectasis and chronic asthma: how common in pediatrics?
Asthma represents one of the most common chronic medical conditions affecting children. Although complications of asthma are rare, they deserve consideration when treating children with asthma. The aim of this study was report our experience with an 11-year-old boy with asthma that was complicated by bronchiectasis and to review our hospital's 10-year experience with bronchiectasis. We observed clinical and laboratory findings in a young boy with chronic asthma who developed bronchiectasis, reviewed medical records of 53 children with bronchiectasis followed at a university children's hospital to identify etiologies of bronchiectasis, and reviewed articles in the medical literature. Complications of asthma along with their diagnosis, pathogenesis, and treatment options are outlined in the discussion section. We describe the case of an 11-year-old boy with chronic asthma who did not respond to conventional asthma management and was found to have bronchiectasis. A detailed workup undertaken to identify the cause was negative for usual etiologies of bronchiectasis. In this patient, bronchiectasis was felt to be secondary to a long-standing history of asthma. Aggressive treatment of bronchiectasis led to significant improvement of asthma. Among 53 patients admitted for bronchiectasis, only 3 cases (5.6%) of asthma were identified. Cystic fibrosis (50.9%) and infection (13.2%) were the most common etiologies identified in our hospital's experience. No clear etiology was identified in 1.8% of patients. Although rare, bronchiectasis does occur in patients with chronic asthma. It is important that complications be recognized and treated for optimal management of asthma.
Rama
Monica
M
Division of Allergy/Immunology, Department of Pediatrics, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, 1600 Rockland Road, Wilmington, DE 19803, USA.
Yousef
Ejaz
E
D000293:Adolescent; D001249:Asthma / Q000150:complications*; D001987:Bronchiectasis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002648:Child; D002908:Chronic Disease; D006785:Hospitals, University; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors