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Bronchiectasis - Management
How is bronchiectasis confirmed and the underlying cause determined in secondary care?
- High-resolution computed tomography (HRCT) scanning is the investigation of choice to establish the diagnosis of bronchiectasis.
- Investigations to determine the underlying cause of bronchiectasis include:
- Further testing for cystic fibrosis — such as sweat chloride or gene testing for all children and adults up to 40 years of age and adults older than 40 years of age with clinical features consistent with cystic fibrosis.
- Screening for gross antibody deficiency — serum IgG (immunoglobulin G), IgA, IgM and electrophoresis for all people with confirmed bronchiectasis.
- Investigation of immunological disorders — such as alpha-1 antitrypsin level, serum IgE, Aspergillus-specific IgE and precipitins; for people with clinical features or risk factors for immunological disorders.
- Bronchoscopy may be indicated for further investigation of lower respiratory tract infection or bronchial obstruction (for example for suspected foreign body aspiration in children or to exclude an endobronchial lesion in adults).
- Gastrointestinal investigations such as 24-hour pH monitoring for people suspected of having bronchiectasis secondary to gastro-oesophageal reflux and aspiration.
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