Source: Annual Congress 2002 - Important lung infections worldwide
Disease area: Respiratory infections

Abstract

Recurrent respiratory tract infections is a frequent cause of referral to specialist centres. Since 1999 we have been screening such patients for a number of pathologies using high resolution CT scanning (HRCT), Immunoglobulin & subclasses (IgG 1-4) and alpha1 antitrypsin (AAT).
METHODS:
Retrospective analysis of case records of 68 patients assessed from 1999 to end of 2001.
RESULT:
35 females, 33 males, mean age 52.3 years, range (17-78); 17 never smokers,
18 patients had bronchiectasis confirmed on HRCT, (not obvious on plain x-ray in 8).
12 patients had sinusitis radiologically.
7/47 patients had reduced alpha1 (AAT), 6 (M) phenotype and 1 MZ.
5/66 had a reduced total IgG. Two patients were diagnosed with severe combined immunodeficiency. 22/66 patients with normal total IgG have at least one IgG subclass deficiency. IgG4 deficiency was the most frequent abnormality seen in 17/66
8 patients with IgG subclass deficiency had bronchiectasis. 3 patients with AAT have bronchiectasis.
[dsquote](table1)[dsquote]
Sputum cultures were positive in 28 cases with Haemophilus Influenzae being the most frequent organism.
Conclusion:
1. Patients presenting with recurrent respiratory infections have a high prevalence of bronchiectasis.
2. As expected HRCT is superior to plain radiography in diagnosing bronchiectasis.
3. Immunodeficiency is relatively common in this patient population.
4. Subclass immunoglobulin deficiency has an important association with bronchiectasis.
5. The role of Ig4 deficiency remains to be better defined.
6. AAT deficiency is associated with recurrent respiratory infections and bronchiectasis.

	IgG1	IgG2	IgG3	IgG4
No.Of patients	9/66	9/66	5/66	17/66

Sputum cultures were positive in 28 cases with Heamophilus influenzae being the most frequent organism.

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Citations should be made in the following way:
T. Azher, R. Rutherford, D. O'Keefe, J. J. Gilmartin (Galway, Ireland). Is an elaborate bronchial sepsis screen in investigating recurrent respiratory infections worthwhile?. Eur Respir J 2002; 20: Suppl. 38, 3808

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