Chest
ReviewsBronchiectasis in Systemic Diseases
Section snippets
Rheumatoid Arthritis
Pleuropulmonary involvement is one of the extra-articular manifestations of rheumatoid arthritis (RA), with a prevalence estimated at < 5%.1718 Pleuropulmonary manifestations of RA include the following: interstitial pulmonary fibrosis; pleural disease (pleuritis with or without effusion, sterile or septic empyema, necrobiotic nodules with bronchopulmonary fistula, or pyopneumothorax); rheumatoid necrobiotic nodules; respiratory tract infection, especially typical and atypical TB; bronchiolitis
Ulcerative Colitis
Extraintestinal manifestations of ulcerative colitis (UC) are common, occurring in up to 45% of patients, and include uveitis, arthritis, skin lesions, and liver disease.75 In contrast, pulmonary involvement in UC was thought to be rare, having been reported in only 3 of 1,400 patients (0.21%) with inflammatory bowel disease (IBD).76 It was not until the publication by Kraft and coworkers77 that respiratory involvement was included in the list of established complications of IBD.78
Since then,
Sarcoidosis
Sarcoidosis is a disease of unknown cause characterized by an excess of helper T lymphocytes at sites of involvement.93In the lung, the noncaseating granulomas occur mainly in the peribronchial, perivascular, and subpleural areas, and in the bronchial mucosa. Endobronchial manifestations of sarcoidosis are common, as confirmed by blind biopsies of apparently normal bronchial mucosa that yield granulomas in up to 37% of patients.94 Although common, it is rarely of sufficient magnitude to cause
Yellow Nail Syndrome
Yellow nail syndrome (YNS) is a rare entity, and its diagnosis is based on clinical criteria since there are no pathognomonic laboratory tests. Samman and White104 first described the association of yellow nails with primary lymphedema in 1964 and termed it the“ yellow nail syndrome.” Two years later, Emerson105described the full triad of slow-growing yellow nails, lymphedema, and pleural effusions; in 1972, Hiller and colleagues106reported that the presence of two of the three symptoms was
AIDS
Pulmonary manifestations in patients with AIDS have been extensively described and include a wide range of infections, as well as inflammatory and neoplastic processes.125126127128 However, the occurrence of bronchiectasis has rarely been noted.4129130131132 The incidence of bronchiectasis in the HIV-infected population remains to be established, since it is frequently undiagnosed because of a low index of suspicion and because chest radiographs may be normal or nonspecific.
The etiology of
Miscellaneous
Bronchial endometriosis with bronchiectasis in a 60-year-old woman with cyclic hemoptysis for 30 years has been reported.142The relationship between pulmonary endometriosis and bronchiectasis remains uncertain. Recurrent bleeding in the airways and interstitium with subsequent inflammation and healing process may be a possible mechanism for the development of bronchiectasis. Infection in the area of bleeding is another possibility.142
Nodular pulmonary amyloidosis was thought to be the cause of
Conclusion
Bronchiectasis is considered an uncommon disorder; however, with the advances in modern medicine, the recognition of this disorder is increasing due to the use of HRCT and to the prolonged life span of multiple diseases that have allowed the time for the development of bronchiectasis. This review intends to present the systemic diseases that have been associated with bronchiectasis and, therefore, to stimulate the physician to search for the development of bronchiectasis in these disorders,
References (148)
Bronchiectasis
Radiol Clin N Am
(1998)- et al.
Airway disease in a subset of nonsmoking rheumatoid patients
Am J Med
(1982) - et al.
Pulmonary manifestations of Sjo¨gren's syndrome
Chest
(1976) - et al.
Respiratory manifestations in primary Sjo¨gren's syndrome: a clinical, functional, and histologic study
Chest
(1985) - et al.
Pulmonary lymphoma in Sjo¨gren's syndrome
Mayo Clin Proc
(1989) - et al.
Differences in the clinical manifestations of sicca syndrome in the presence and absence of rheumatoid arthritis
Am J Med
(1979) - et al.
The chest radiograph in ankylosing spondylitis
Clin Radiol
(1975) - et al.
Pulmonary diffuse amyloidosis and ankylosing spondylitis
Chest
(1992) - et al.
Pleuropulmonary manifestations of systemic lupus erythematosus
Rheum Dis Clin N Am
(1994) - et al.
Pulmonary function of nonsmoking patients with systemic lupus erythematosus
Chest
(1988)
Pneumothorax in the Marfan syndrome: prevalence and therapy
Ann Thorac Surg
Bronchiectasis and spontaneous pneumothorax in Marfan's syndrome
Chest
The epidemiologic and demographic characteristics of inflammatory bowel disease: an analysis of a computerized file on 1400 patients
J Chronic Dis
Diffuse panbronchiolitis preceding ulcerative colitis
Chest
Pulmonary involvement in ulcerative colitis
Br J Dis Chest
Are there characteristic alterations of lung tissue associated with Crohn's disease?
Pathol Res Pract
Bronchial stenosis in chronic sarcoidosis
Chest
Bronchiectasis: update of an orphan disease
Am Rev Respir Dis
Peripheral bronchial involvement in relapsing polychondritis: demonstration by thin-section CT
AJR Am J Roentgenol
AIDS associated bronchiectasis: CT features
J Comput Assisted Tomogr
High resolution computed tomography of the lungs in patients with rheumatoid arthritis and interstitial lung disease
Br J Rheum
Lung changes in rheumatoid arthritis: CT findings
Radiology
High resolution computed tomography of the lung in lifelong non-smoking patients with rheumatoid arthritis
Ann Rheum Dis
Use of high resolution computed tomography of the lungs in patients with rheumatoid arthritis
Ann Rheum Dis
High-resolution chest CT in systemic lupus erythematosus
AJR Am J Roentgenol
Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis: correlation with clinical findings, pulmonary function testing and plain radiography
Br J Rheum
Airways involvement in rheumatoid arthritis
Am J Respir Crit Care Med
Clinical and imaging aspects of bronchiectasis
Accuracy of CT in predicting the cause of bronchiectasis
Clin Radiol
CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types
AJR Am J Roentgenol
Reduction in bronchial subdivision in bronchiectasis
Thorax
Prevalence of pulmonary involvement in rheumatoid arthritis and its relationship to some characteristics of the patients: a radiological and clinical study
Scand J Rheumatol
Prevalence of symptomatic bronchiectasis in patients with rheumatoid arthritis
Revue Rhum (English)
Bronchiectasis. a late feature of severe rheumatoid arthritis
Medicine
Rheumatoid interstitial lung disease
Br J Dis Chest
Pulmonary infections and rheumatoid arthritis
Q J Med
Bronchiectasis and rheumatoid disease: is there an association?
Br J Rheum
Pulmonary lesions and rheumatoid arthritis
Medicine
Rheumatoid arthritis and chronic bronchial suppuration
Scand J Rheumatol
Bronchiectasis and rheumatoid arthritis: a clinical study
Ann Rheum Dis
Younger onset of rheumatoid arthritis in patients with bronchiectasis [abstract]
Br J Rheumatol
Chemotaxis of polymorphonuclear leukocytes from patients with rheumatoid arthritis
J Clin Invest
Defective monocyte cytotoxicity in rheumatoid arthritis: a correlation with disease activity and reversal by levamisole
Arthritis Rheum
Frequency of infections among rheumatoid arthritis patients, before and after disease onset
Arthritis Rheum
Frequency of infection among patients with rheumatoid arthritis versus patients with osteoarthritis or soft tissue rheumatism
Arthritis Rheum
Opportunistic infection during treatment with low dose methotrexate
Am J Respir Crit Care Med
Airways disease in rheumatoid arthritis patients: one element of a general exocrine dysfunction
Arthritis Rheum
Airway obstruction and rheumatoid arthritis
Eur Respir J
HLA associations in subjects with rheumatoid arthritis and bronchiectasis but not with other pulmonary complications of rheumatoid disease
Br J Rheumatol
Cited by (139)
Pulmonary Pathology in Rheumatic Disease
2019, Clinics in Chest MedicineMarked deterioration in rheumatoid arthritis associated bronchiectasis following treatment with Rituximab
2019, Respiratory Medicine Case ReportsDiffuse bronchiectasis as the primary manifestation of endobronchial sarcoidosis
2017, Respiratory Medicine Case ReportsLung involvement in inflammatory rheumatic diseases
2016, Best Practice and Research: Clinical RheumatologyCitation Excerpt :In these patients, the infection appears to trigger B cells, which potentiate chronic inflammatory damage [61]. It has also been proposed that RA and BR may share a similar genetic predisposition [62]. It is also plausible that DMARDs suppress the immune system and predispose to pulmonary infection, contributing to the development of BR.
Tracheitis – A Rare Extra-Intestinal Manifestation of Ulcerative Colitis in Children
2016, GE Portuguese Journal of GastroenterologyDiagnostic challenges of bronchiectasis
2016, Respiratory MedicineCitation Excerpt :One of the proposed theories suggests that this is because inflammatory mediators change from the resected intestine to the lung due to their common embryological origin [52]. In some cases, treatment with inhaled and oral glucocorticosteroids has been effective, including their instillation via bronchoalveolar lavage [42], but there is insufficient evidence to prescribe this treatment routinely [1,2]. Primary ciliary dyskinesia (PCD) is a rare aetiology characterized by early onset.