Bronchiectasis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

There are both routine investigations and special case investigations. Routine investigations include sputum analysis, full blood count, and quantitative immunoglobulin levels. Cystic fibrosis and autoimmune testing are done if the patient is suspected of having an underlying condition.

Bronchiectasis Laboratory Findings

Sputum Analysis

  • Observe for Dittrich plugs (foul smelling masses of bacteria), white or yellow concretions
  • A gram stain and culture should be performed

Full Blood Count

Quantitative Immunoglobulin Levels

  • Measure IgG, IgA, IgM, and serum electrophoresis to exclude hypogammaglobulinemia
  • Serum IgE or skin prick testing or IgE radioallergosorbent test for ABPA
  • Diagnostic criteria include a total serum IgE level greater than 1000 IU/mL or a greater than 2-fold rise from baseline
  • Antibodies to Haemophilus influenza type B or Streptococcus pneumonia

Quantitative Serum Alpha 1-antitrypsin (AAT) Levels

  • This is used to rule out AAT deficiency

Tests for Ciliary Function

Testing for Cystic Fibrosis

  • Two measurements of sweat chloride and cystic fibrosis transmembrane regulator (CFTR) genetic mutation analysis should be done for all children and adults up to 40 years
  • If the the patient is more than 40 years, he should do cystic fibrosis testing if he has persistent isolation of Staphylococcus aureus in the sputum, features of malabsorption, male primary infertility, upper lobe bronchiectasis, or a history of childhood steatorrhoea

24-hour pH Monitoring

  • This testing is for those who are suspected of having bronchiectasis secondary to gastrointestinal reflux or aspiration.\

Autoimmune Screening Tests

  • These test should be done if the patient is suspected of having an autoimmune disorder such as Rheumatoid Arthritis

References

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