Diagnóstico y tratamiento de bronquiectasias en pacientes pediátricos sin fibrosis quística.

Abstract

Bronchiectasis is characterized by the permanent dilation of bronchi, clinically presenting with chronic cough, sputum production, dyspnea, and recurrent exacerbations. Bronchiectasis can occur due to genetic disorders, congenital malformations, endobronchial obstruction of infectious and inflammatory origin, and chronic aspiration, among other causes. Bronchial dilation leads to impaired mucociliary clearance, trapping particles and microorganisms in the airways. Macrophages and epithelial cells release proinflammatory cytokines that promote neutrophil chemotaxis. Neutrophils release enzymes causing epithelial cell damage, reducing ciliary motility, promoting glandular hyperplasia, and increasing mucus secretion. Persistent infection perpetuates local inflammation in bronchiectasis patients. Diagnosis requires high clinical suspicion and early detection improves clinical outcomes. High-resolution computed tomography is the gold standard for confirmation. A comprehensive medical history, initial assessments with complete blood count, total serum immunoglobulins, iontophoresis, and spirometry help assess the underlying etiology and disease severity. The primary goal is preserving lung function and halting disease progression. This involves adopting healthy lifestyles, expanded vaccination schedules, respiratory therapy, and early antibiotic use for exacerbations and colonization by specific microorganisms.