Katerina Dimakou1,2, Adamantia
Toumbis1,2, Anna Gkousiou3, Serafeim
Tsikritsaki1,2, Loukas Thanos4 and Christina
Pulmonary Department, Sotiria Chest Hospital, Athens, Greece,?26th
Pulmonary Department, Sotiria Chest Hospital, Athens, Greece,?3American
College, American College, Derree, Athens, Greece,?4Radiology
Department, Sotiria Chest Hospital, Athens, Greece
Bronchiectasis may contribute to severe asthma.
estimate the presence of bronchiectasis in severe asthma and the
relation with the clinical and functional parameters.
included patients with severe uncontrolled asthma.Symptoms, number of
exacerbations/year, courses of corticosteroids and antibiotics/year,
spirometry, and bronchial colonization were estimated. The Smith scale
for bronchiectasis was estimated by HRCT (score 0-24), taking a
score≥3 as radiologically significant.
Forty patients were studied, 28 women, mean age 57.9 years, 32 non
smokers. Mean ACT score was 14.2.The main symptoms were: cough (92%),
wheezing (95%), dyspnea (92%), sputum production (72%) of which mucoid
(52%), mucopurulent and purulent (48%). Exacerbations: 4.4/year,
corticosteroid courses/year:4.4, antibiotic courses/year:2.8.In 27
patients (67,5%) bronchiectasis was diagnosed: score 5.2.
The mean FEV1
72.6%. Nine patients (22.5%) were colonized with pathogens, 6 of whom
with Pseudomonas Aeruginosa. Patients with sputum
production had a higher smith score compared to those without
expectoration (p=0.005). Patients with pathogens in sputum cultures had
a higher smith score compared to those with normal flora
No correlation was found
extent of bronchiectasis and the lung function parameters.The severity
of bronchiectasis was correlated to the number of antibiotic
courses/year (p=0.002). Lower ACT score was related with a higher
asthma exacerbation rate (p=0.001).
The evidence of bronchiectasis on HRCT is common in patients with
severe asthma. Sputum production and pathogen isolation may indicate
the presence of this comorbidity and the need of antibiotics as an