Chest
Volume 116, Issue 4, October 1999, Pages 1063-1074
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Reviews
Bronchiectasis in Systemic Diseases

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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,

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