Reverse Angle: Immunological Evaluation of Patients with Bronchiectasis

Objective: Bronchiectasis is a chronic debilitating disease of the airways that results in chronic cough and production of viscous sputum due to dilatation of the airways and bronchial wall thickening. Although bronchiectasis is a common problem in immunodeficiencies and a well-known complication of these disorders, there are a limited number of studies on the frequency of immune abnormalities in adult patients with bronchiectasis. Materials and Methods: The records of adult patients who visited the Pulmonology Outpatient Clinic and whose immune system was assessed due to bronchiectasis at the Immunology Outpatient Clinic until June 2018 were retrospectively evaluated. The data of 84 patients with bronchiectasis (mean age: 48.5 ± 17.9 years, female: 45 [53.6%], male: 39 [46.4%]) were analyzed. Results: Six patients (7.1%) had at least one antibody deficiency. Four patients (4.8%) had low IgG levels, one (1.2%) had low IgA level, and one (1.2%) had low IgM level. Fourteen patients (16.7%) had high IgG (16-22 g/l), 10 (11.9%) high IgA (4.08 - 6.60 g/l) and one (1.2%) high IgM (8.87 g/l). Thirty-five patients (41.7%) had at least one abnormality in the peripheral lymphocyte subset analyses. Conclusion: Adult patients with bronchiectasis may have a variety of immunological abnormalities in addition to hypogammaglobulinemia. Therefore, clinicians should not overlook immunological evaluation in the etiological investigation of bronchiectasis, and patients with immunological abnormalities should be closely monitored.

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