Bronchiectasis is a bronchopulmonary disorder characterized by abnormal bronchial wall thickening and dilatation of central and medium sized bronchi caused by repeated cycles of airway infection and inflammation with mediator release (1).
It is usually accompanied by a chronic cough, mucopurulent sputum production and recurrent infections (2).
This condition may be due to an increased outward traction on the bronchi and weakness of the bronchial wall due to inflammation.
It may present in two forms:
- local or focal obstructive bronchiectasis
- limited to a lobe or a segment of the lung
- recognition is important since local intervention with bronchoscopic procedures or surgery may help in palliation and sometimes cure
- diffuse bronchiectasis
- widespread involvement of both lung
- often associated with other sinopulmonary diseases (sinusitis, asthma) (3)
Bronchiectasis may be caused by the genetic disease cystic fibrosis (CF) or can occur in patients without CF (non-CF bronchiectasis) (4):
- non-CF bronchiectasis is more common in women and older people and in patients with acid reflux, asthma, and chronic obstructive pulmonary disease (COPD).
- other risk factors include:
- a history of pneumonia,
- infection with nontuberculous mycobacteria or tuberculosis,
- certain genetic conditions (such as α1-antitrypsin deficiency),
- autoimmune diseases (such as rheumatoid arthritis and inflammatory bowel disease),
- immunodeficiency (such as common variable immunodeficiency), and cigarette smoking
- in up to 40% of cases, the cause of non-CF bronchiectasis is unknown
References:
- ten Hacken NH, van der Molen T. Bronchiectasis. BMJ. 2010 Jul 14;341:c2766. doi: 10.1136/bmj.c2766. PMID: 20630967.
- Chalmers JD, Chang AB, Chotirmall SH, Dhar R, McShane PJ. Bronchiectasis. Nat Rev Dis Primers. 2018 Nov 15;4(1):45. doi: 10.1038/s41572-018-0042-3.
- Barker AF. Bronchiectasis. N Engl J Med. 2002 May 2;346(18):1383-93. doi: 10.1056/NEJMra012519.
- Walter KL. What Is Bronchiectasis? JAMA. Published online August 07, 2025.