Bronchiectasis in childhood in the state of Qatar

Abstract EN

We reviewed 35 cases of bronchiectasis seen at the Department of Pediatrics of Hamad Medical Corporation in the State of Qatar.

The main objective was to determine the etiology and the clinical features and to evaluate their management.

Ages ranged from 7 months to 12 years with a mean of 63.8 months.

The male to female ratio was 1.7:1 and 23 (65.9%) of the cases were diagnosed before the age of six years.

Cough was present in every case and rales in 30 (85.7%) of the cases.

Dyspnea, wheezing, clubbing and failure to thrive were found less frequently.

The cause of the bronchiectasis was unidentifiable in almost 50% of the cases and in the remainder it was due to childhood infection (2 cases), congenital and genetic disorders (6 cases, including 4 cases of cystic fibrosis, 1 case of ciliary dyskinesia and 1 case with congenital right middle lobe bronchus stenosis), immune defects (4 cases), airway obstruction (4 cases, including two cases of foreign body aspiration), extrinsic compression (1 case), bronchial asthma with right middle lobe syndrome (1 case) and four miscellaneous cases: Down’s syndrome withA-Vcanal (1 case), persistent RLL atelectasis (2 cases), and mediastinal lymphadenopathy with persistent LLL atelectasis (1 case).

Of the various diagnostic methods available, CT was found to be the most conclusive and surpasses the other diagnostic modifies of bronchiectasis in children and should then be resorted to any clinical suspicion of the disease.

The outcome of medical treatment, (excluding 4 cases of cystic fibrosis) was that 7 cases missed follow-up, 7 cases responded favorably, 4 cases remained unchanged, 2 cases died (one with HIV and one with Down’s syndrome and congenital heart disease) and 11 cases were referred for surgery.

Both medical and surgical treatments are discussed and the recommendations for surgery outlined.