title: Phenotyping adults with non-cystic fibrosis bronchiectasis: a prospective observational cohort study.
abstract: BACKGROUND
  Bronchiectasis is the outcome of a number of different airway insults. Very few studies have characterised the aetiology and utility of a dedicated screening proforma in adult patients attending a general bronchiectasis clinic.
  
  
  METHODS
  A prospective observational study of 189 bronchiectasis patients attending two centres in the North East of England over a two-year period was performed.
  
  
  RESULTS
  The aetiology of bronchiectasis was identified in 107/189(57%) patients. Idiopathic bronchiectasis (IB) represented the largest subgroup (43%). Post-infection bronchiectasis (PIB) constituted the largest proportion (24%) of known causes. Mean age (SD) at diagnosis was 54(20) years with a mean age at symptom onset of 37(24) years, accounting for a diagnostic delay of 17 years. Age of symptom onset was significantly younger in patients with PIB compared to IB (p < 0.0001) and in Pseudomonas sputum positive patients (p = 0.007). Screening for APBA and total immunoglobulin deficiency identified 9 (5%) patients who then had tailored treatment. Routine screening for other aetiologies was deemed unnecessary.
  
  
  CONCLUSIONS
  IB and PIB accounted for two thirds of cases of bronchiectasis in a general population. We recommend routine screening for ABPA and total immunoglobulin deficiency but not for other rarer aetiologies.
authors.affiliation: Department of Respiratory Medicine, Northumbria Healthcare Trust, Newcastle, UK. ghznfr7@hotmail.com
authors.forename: G A
authors.initials: GA
authors.lastname: Anwar
authors.forename: M J
authors.initials: MJ
authors.lastname: McDonnell
authors.forename: S A
authors.initials: SA
authors.lastname: Worthy
authors.forename: S C
authors.initials: SC
authors.lastname: Bourke
authors.forename: G
authors.initials: G
authors.lastname: Afolabi
authors.forename: J
authors.initials: J
authors.lastname: Lordan
authors.forename: P A
authors.initials: PA
authors.lastname: Corris
authors.forename: A
authors.initials: A
authors.lastname: DeSoyza
authors.forename: P
authors.initials: P
authors.lastname: Middleton
authors.forename: C
authors.initials: C
authors.lastname: Ward
authors.forename: R M
authors.initials: RM
authors.lastname: Rutherford
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology / Q000628:therapy; D003550:Cystic Fibrosis / Q000150:complications; D057210:Delayed Diagnosis; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000172:deficiency; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D007136:Immunoglobulins