Structural and functional lung disease in primary ciliary dyskinesia.
BACKGROUND
High-resolution CT (HRCT) scan data on primary ciliary dyskinesia (PCD) related lung disease are scarce.


OBJECTIVE
We evaluated the lung disease in children and adults with PCD by a modified Brody composite HRCT scan score to assess the prevalence of the structural abnormalities; to evaluate the correlation among HRCT scan scores, spirometry findings, and clinical data; and to compare the PCD scores with those of age-matched and sex-matched cystic fibrosis (CF) patients.


METHODS
Twenty PCD patients (age range, 4.6 to 27.5 years) underwent HRCT scanning, spirometry, and deep throat or sputum culture. A modified Brody score was used to assess bronchiectasis, mucous plugging, peribronchial thickening, parenchyma abnormalities, and mosaic perfusion.


RESULTS
The total HRCT scan score was 6% of the maximal score (range, 0.5 to 25.5). Subscores were as follows: bronchiectasis, 5.6%; mucous plugging, 5.6%; peribronchial thickening, 8.3%; parenchyma, 3%; and mosaic perfusion, 0%. The prevalence of lung changes were as follows: bronchiectasis, 80%; peribronchial thickening, 80%; mucous plugging, 75%; parenchyma, 65%; and mosaic perfusion, 45%. Sixteen of 19 PCD patients had positive culture findings, and the most common pathogen found was Haemophilus influenzae (84%). The total HRCT scan score was significantly related to age (p = 0.006), FEV(1) (p = 0.02), and FVC (p = 0.02). The bronchiectasis subscore was significantly related to FEV(1) (p = 0.04) and FVC (p = 0.03). In CF patients, the total HRCT scan score was significantly higher than that in PCD patients (p = 0.02).


CONCLUSIONS
PCD patients show significantly lower pulmonary HRCT scan scores than CF patients. The PCD total and bronchiectasis scores correlate with spirometry findings. The PCD HRCT scan score might be used for longitudinal assessment and/or represent an outcome surrogate in future studies.
Santamaria
Francesca
F
Department of Pediatrics, Federico II University, Naples, Italy.
Montella
Silvia
S
Department of Pediatrics, Federico II University, Naples, Italy.
Tiddens
Harm A W M
HAWM
Department of Diagnostic Imaging, Radiology Service, AORN Antonio Cardarelli, Naples, Italy.
Guidi
Guido
G
Department of Diagnostic Imaging, Radiology Service, AORN Antonio Cardarelli, Naples, Italy.
Casotti
Valeria
V
Department of Pediatric Pulmonology and Allergology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
Maglione
Marco
M
Department of Pediatrics, Federico II University, Naples, Italy.
de Jong
Pim A
PA
Department of Pediatric Pulmonology and Allergology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. Electronic address: pimdejong@gmail.com.
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007619:Kartagener Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D012720:Severity of Illness Index; D013147:Spirometry; D014057:Tomography, X-Ray Computed