Version June 2024
| Comorbidities seen in children and adults | |
| Malnutrition | Children with bronchiectasis are threefold more likely to have a history of malnutrition before diagnosis of bronchiectasis[1]. Up to three-quarters of indigenous children with bronchiectasis have poor weight gain[2]. High body mass index is associated with improved survival in adults with bronchiectasis[3,4]. |
| Vitamin D deficiency | Vitamin D deficiency is associated with increased risk for respiratory infections and more severe bronchiectasis[5-7]. |
| Hemoptysis | Up to 10% of children presenting to tertiary hospitals with hemoptysis have underlying bronchiectasis[8]. Hemoptysis is a marker for advanced lung disease and can be life-threatening. |
| Osteopenia | Osteopenia is more common in children with bronchiectasis compared with controls; the risk of osteoporosis and osteopenia increases with age[9]. |
| Asthma-like symptoms | Asthma can coexist with bronchiectasis and is a poor prognostic factor[2,10-12]. In some cases, bronchiectasis is wrongly labeled as asthma before a diagnosis is made. |
| Sleep disturbance | Patients with bronchiectasis, particularly those with nocturnal symptoms, often have disturbed sleep and poor sleep quality. The risk increases with disease severity[13]. |
| Hypoxemia/pulmonary hypertension | Patients with longstanding and severe bronchiectasis may develop pulmonary hypertension and hypoxemia[14]. This is caused by destruction of the pulmonary vascular bed and chronic hypoxia. |
| Poor dental health | A possible link has been suggested between oral health and pulmonary disease, including bronchiectasis. The proposed mechanism is that oral disease pathogens are aspirated into the lung, where they contribute to the pulmonary disease[15,16]. There are no data on dental or oral hygiene in children with bronchiectasis. |
| GERD | GERD symptoms are common in adults and children with bronchiectasis[10,17,18]. GERD is thought to be a contributor to the disease process, but benefits of treating GERD have not been proven. Furthermore, treatment of GERD by gastric acid suppression is associated with other adverse events including increased risk for respiratory infections (although this may be due to confounding rather than a causal effect)[19]. |
| Reduced exercise capacity | Children with bronchiectasis have reduced exercise capacity, physical activity, and fundamental movement skills[20-23]. |
| Comorbidities reported in adults but not in children | |
| Broncholithiasis | Broncholithiasis (bronchial stones) has been described in several adult patients with localized bronchiectasis[24]. |
| Cardiac morbidity | In adult patients with bronchiectasis, cardiac findings may include higher pulmonary artery pressure, lower myocardial performance index, and right and left ventricular systolic dysfunction[25,26]. In a study in children, ventricular systolic functions were preserved, but some had changes in left ventricular diastolic function[27]. |
| Hypertrophic osteoarthropathy | Hypertropic osteoarthropathy is characterized by periostosis of the tubular bones, arthritis-like features, and digital clubbing. It is an established association with bronchiectasis in patients with cystic fibrosis[28] and has also been described in case reports of adults and children with bronchiectasis unrelated to cystic fibrosis[29,30]. |
| Systemic amyloidosis | Bronchiectasis has been reported as 1 of the causes of amyloidosis in case series of amyloidosis[31,32]. Amyloidosis is also a rare complication of cystic fibrosis[33]. |
| Lung cancer or any cancer | Epidemiologic data from Taiwan, based on more than 50,000 patients[34,35]. |
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