Clinical profile of Saudi children with bronchiectasis

Objective. This study represents the experience of a tertiary care center in Saudi Arabia on non- cystic fibrosis bronchiectasis. Methods. A retrospective review of all patients with confirmed Non- Cystic Fibrosis ( Non- CF) bronchiectasis by chest X- ray and or CT chest in a pulmonary clinic for the period 1993- 2005 at a tertiary care center in Riyadh. Results. A total of 151 cases were diagnosed as Non- CF bronchiectasis. Seventy- five ( 49.7%) were males, 76( 50.3%) were females. One hundred forty- eight ( 98%) are alive and 3( 2%) died. The southwestern regions constituted 72( 50%) of the cases. There is a period ( 5 +/- 3.2) years between the start of symptoms and the diagnosis of bronchiectasis. More than 2/ 3 of the patients had cough, tachypnea, wheezing, sputum production and failure to thrive. Ninety one ( 60%) had associated disease: Pulmonary diseases in 48( 32%), immunodefficiency in 27( 18%), CNS in 18( 12%), cardiac in 12( 8%), and asthma in 103( 68%) of the patients. Left lower lobes were commonly involved in 114( 76%) cases. Sixty- eight ( 67%) were found to have sinusitis. Forty- nine ( 32%) developed gastroesophgeal reflux ( GER). Hemophilus influenza was cultured in 56( 37%), Strept pneumoniae in 25( 17%), and Pseudomonas aeruginosa in 24( 16%) of the patients. 80% of the patients who had pulmonary function test had abnormal changes. Disease progression was related to development of symptoms before 5 years of age, persistent atelectasis, and right lower lobe involvement ( p < 0.05). Conclusion. Non- CF bronchiectasis is a common problem in Saudi Arabia. Early recognition and institution of treatment with proper vaccination of available anti- bacterial and anti- viral vaccines are encouraged to prevent progression of the disease.