| Popis: |
Background: Bronchiectasis and asthma may share some characteristics and a number of patients may have both conditions. Aim: To examine the rationale of prophylactic inhaled steroids prescription in children with bronchiectasis Methods: Data of children attended in our department with radiologically established bronchiectasis were retrospectively reviewed. Spirometric indices, presence of wheezing, dyspnea on exertion, use of prophylactic inhaled steroids, inhaled salbutamol on an as-needed basis, and mosaic attenuation on expiratory CT scans were recorded. Results: We retrieved data for 22 girls and 19 boys (mean±sd age: 9.0±3.8 years old) with radiologically established bronchiectasis. There were 18 (43.9%) patients with radiological signs of obstruction. Seventeen (41.6%) and 6 (14.1%) children had episodes of wheezing or reported dyspnea on exertion in the previous two years, respectively. Mean±sd percent predicted FEV1 and FEV1/FVC were 91.2±21.2, and 82.8±10.1, respectively. Twenty (48.8%) patients were using salbutamol on as-needed basis. Nineteen (46.3%) patients had received inhaled steroids for at least 3 months. Radiological signs of air trapping were correlated with FEV1, FEV1/FVC ratio, presence of wheeze, and dyspnea on exertion (r= -0.47, p-0=001, and r= -0.43, p=0.017, and r= 0.44, p=0.003, and r= 0.37, p=0.015, respectively). Conclusions: Radiological signs of obstruction are correlated with obstructive spirometric pattern and asthma-like symptoms/signs. The difficulty to set the diagnosis of real asthma in cases of bronchiectasis justifies the therapeutic trial of inhaled steroids in patients with bronchiectasis and evidence of airways obstruction. |
