Bronchial Hyperresponsiveness in Pediatric Non‐Cystic Fibrosis Bronchiectasis
Lisa Gerbeau, Armelle Finet, Margaux Bertrand, Emmanuelle Bosdure, Laura Papazian, Kenza Tahiri, Melisande Baravalle, Julie Mazenq, Jean‐Christophe DubusABSTRACT
Objective
The prevalence and significance of bronchial hyperresponsiveness (BHR) in patients with non‐cystic fibrosis (CF) bronchiectasis remain unclear. The objective is to determine the prevalence of BHR, defined as a post‐bronchodilator forced expiratory volume in 1 s (FEV1) improvement > 10%, in children with non‐CF bronchiectasis and to assess its association with clinical, functional, and radiological characteristics.
Design
This retrospective, observational monocentric study included children with non‐CF bronchiectasis followed‐up at an university center for rare pediatric respiratory diseases.
Patients
Patients were eligible if they had performed spirometry with bronchodilator reversibility testing within 3 years of a diagnostic chest computed tomography (CT).
Main Outcomes Measures
Asthma symptoms, asthma exacerbations, asthma treatments, allergic markers, infectious exacerbations, causes of bronchiectasis, FEV1, FEV1/forced vital capacity (FVC) ratio, reversibility, and mosaic attenuation on CT were compared between patients with and without BHR.
Results
Among 157 patients, 65 (male/female sex ratio 0.71, mean age 10 years old, asthma symptoms in over 56% of patients, 67% treated with inhaled corticosteroids) met the inclusion criteria. BHR was present in 32.3% of cases. Patients with BHR had a significantly altered lung function (baseline Z‐score FEV1 −2.12 vs −0.87; FEV1/FVC −2.28 vs −0.85). No significant association was found between BHR and clinical and radiological characteristics.
Conclusion
BHR is not associated with clinical, radiological or therapeutic characteristics in pediatric non‐CF bronchiectasis, except a more severe airflow limitation. These findings highlight the importance of lung function assessment for non‐CF bronchiectasis patients.