Non cystic fibrosis-related bronchiectasis in children: etiological structure, clinical and laboratory and computed tomographic characteristics
- Authors: Frolov P.A.1,2, Zhestkova M.A.1, Ovsyannikov D.Y.1,2, Ayrapetyan M.I.3, Topilin O.G.2, Korsunskiy A.A.3,4, Bojcova E.V.5, Zapevalova E.Y.6, Orlov A.V.7, Makarenko H.V.1, Marchenkov Y.V.8, Berezhanskiy P.V.1,2, Gorev V.V.2
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Affiliations:
- People’s Friendship University of Russia (RUDN University)
- Morozov Children's City Clinical Hospital
- Sechenov First Moscow State Medical University (Sechenov University)
- Speransky Children's City Clinical Hospital №9
- Saint Petersburg State Pediatric Medical University
- Pavlov First Saint Petersburg State Medical University
- Saint Olga Children's City Hospital
- Clinical and diagnostic center "Medsi"
- Issue: No 2 (2022)
- Pages: 166-173
- Section: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/109560
- DOI: https://doi.org/10.26442/26586630.2022.2.201679
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Abstract
Aim. To establish the etiological structure and to present clinical and laboratory and instrumental characteristics of bronchiectasis (BE) not associated with cystic fibrosis (CF) in children.
Materials and methods. Sixty-seven hospitalised patients with BЕ not related to CF were followed up between 2017 and 2022. Examination methods: clinical-anamnestic method, general clinical laboratory investigations, investigation of allergological and immune status, phagocytosis system, determination of concentration of specific IgE and IgG to fungi of genus Aspergillus, sweat test, radiological examination and computed tomography (CT) of chest organs, bronchoscopy, Bacteriological examination of sputum and/or tracheobronchial aspirates, nasal and/or bronchial ciliary motility, esophagogastroduodenoscopy, 24-hour pH-metry, intra-esophageal combined impedance-pH-metry, genetic study, lung biopsy.
Results. Etiologic factors of BЕ not associated with CF in children were severe pneumonia (22%), primary ciliary dyskinesia (22%), bronchial asthma (13%), Williams-Campbell syndrome (7%), bronchial foreign bodies (7%), gastroesophageal reflux disease (6%), Bronchopulmonary dysplasia (6%), postinfectious bronchiolitis obliterans (5%), allergic bronchopulmonary aspergillosis (3%), chronic granulomatous disease (3%), AIDS (1%), prolonged bacterial bronchitis (1%), brain-lung-thyroid syndrome (1%). The clinical picture is characterized by cough (91%), shortness of breath (67%), fever during exacerbation (48%), chest pain (24%), exercise intolerance (55%), drumstick symptom (9%), moist (76%) and dry wheezing (37%). CT-semiotics of BЕ not associated with CF is characterized by localization in one (58%) or several (42%) lobes; traction (42%), non-traction (49%) B and their combination (9%); increased broncho-arterial ratio >0.9; thickening of bronchial wall; "mosaic perfusion"/"air-trap" symptom (9%); more frequent involvement of lower lungs (64%). The main infectious agents in BЕ not associated with CF were Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus.
Conclusion. On the basis of a multicentre study, the etiological structure, clinical and laboratory and CT-characteristics of non-CF ВE in children were established.
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About the authors
Pavel A. Frolov
People’s Friendship University of Russia (RUDN University); Morozov Children's City Clinical Hospital
Author for correspondence.
Email: 9715586@gmail.com
ORCID iD: 0000-0001-6564-9829
Аssistant, pulmonologist, People’s Friendship University of Russia (RUDN University), Morozov Children's City Clinical Hospital
Russian Federation, Moscow; MoscowMariya A. Zhestkova
People’s Friendship University of Russia (RUDN University)
Email: dr.zhestkova@gmail.com
ORCID iD: 0000-0003-4937-716X
Cand. Sci. (Med.), People’s Friendship University of Russia (RUDN University)
Russian Federation, MoscowDmitriy Yu. Ovsyannikov
People’s Friendship University of Russia (RUDN University); Morozov Children's City Clinical Hospital
Email: mdovsyannikov@yahoo.com
ORCID iD: 0000-0002-4961-384X
D. Sci. (Med.), People’s Friendship University of Russia (RUDN University), Morozov Children's City Clinical Hospital
Russian Federation, Moscow; MoscowMaxim I. Ayrapetyan
Sechenov First Moscow State Medical University (Sechenov University)
Email: mdgkb@zdrav.mos.ru
ORCID iD: 0000-0002-0348-929X
Assoc. Prof., Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation, MoscowOleg G. Topilin
Morozov Children's City Clinical Hospital
Email: mdgkb@zdrav.mos.ru
ORCID iD: 0000-0002-5302-0502
Department Head, Morozov Children's City Clinical Hospital
Russian Federation, MoscowAnatoly A. Korsunskiy
Sechenov First Moscow State Medical University (Sechenov University); Speransky Children's City Clinical Hospital №9
Email: korsunskyAA@zdrav.mos.ru
ORCID iD: 0000-0002-9087-1656
D. Sci. (Med.), Prof., Sechenov First Moscow State Medical University (Sechenov University), Speransky Children's City Clinical Hospital №9
Russian Federation, Moscow; MoscowEvgeniya V. Bojcova
Saint Petersburg State Pediatric Medical University
Email: evboitsova@mail.ru
ORCID iD: 0000-0002-3600-8405
D. Sci. (Med.), Saint Petersburg State Pediatric Medical University
Russian Federation, Saint PetersburgElena Yu. Zapevalova
Pavlov First Saint Petersburg State Medical University
Email: elena.zapevalova-13@yandex.ru
ORCID iD: 0000-0002-4337-3902
Res. Assist., Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint PetersburgAleksander V. Orlov
Saint Olga Children's City Hospital
Email: orlovcf@yandex.ru
ORCID iD: 0000-0002-2069-7111
Cand. Sci. (Med.), Saint Olga Children's City Hospital
Russian Federation, Saint PetersburgHelen V. Makarenko
People’s Friendship University of Russia (RUDN University)
Email: makelenavit@mail.ru
ORCID iD: 0000-0001-5598-8413
Аssistant, People’s Friendship University of Russia (RUDN University)
Russian Federation, MoscowYaroslav V. Marchenkov
Clinical and diagnostic center "Medsi"
Email: dr.marchenkov@gmail.com
ORCID iD: 0000-0002-5906-0230
Cand. Sci. (Med.), Clinical and diagnostic center "Medsi"
Russian Federation, MoscowPavel V. Berezhanskiy
People’s Friendship University of Russia (RUDN University); Morozov Children's City Clinical Hospital
Email: 9715586@gmail.com
ORCID iD: 0000-0001-5235-5303
Cand. Sci. (Med.), People’s Friendship University of Russia (RUDN University), Morozov Children's City Clinical Hospital
Russian Federation, Moscow; MoscowValerii V. Gorev
Morozov Children's City Clinical Hospital
Email: mdgkb@zdrav.mos.ru
ORCID iD: 0000-0001-8272-3648
Cand. Sci. (Med.), Morozov Children's City Clinical Hospital
Russian Federation, MoscowReferences
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