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Original Research |

Bronchiectasis in a Diverse US PopulationEtiology of Bronchiectasis According to Ethnicity: Effects of Ethnicity on Etiology and Sputum Culture

Pamela J. McShane, MD; Edward T. Naureckas, MD, FCCP; Mary E. Strek, MD, FCCP
Author and Funding Information

From the Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL.

Correspondence to: Pamela J. McShane, MD, Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago Medical Center, 5841 S Maryland Ave, MC 6076, Chicago, IL 60637; e-mail: pmcshane@medicine.bsd.uchicago.edu

Financial/nonfinancial disclosures: Dr Naureckas has received institutional grants from GlaxoSmithKline plc; Gilead Sciences, Inc; the Cystic Fibrosis Foundation; and Mpex Pharmaceuticals, Inc, to conduct clinical research trials. Dr Strek has received institutional grants from Gilead Sciences, Inc; Pharmaxis Inc; and the Cystic Fibrosis Foundation to conduct clinical research trials. Dr McShane has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Funding/Support: The authors have reported to CHEST that no funding was received for this article.


Drs Naureckas and Strek contributed equally to this work.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: The authors have reported to CHEST that no funding was received for this article.


Chest. 2012;142(1):159-167. doi:10.1378/chest.11-1024
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Background:  Previous studies of patients with bronchiectasis have found that the cause is idiopathic in the majority of cases, but these studies were done in homogeneous populations. We hypothesized that the etiology of bronchiectasis can be determined in a higher percentage of patients in a diverse US population and will differ significantly based on ethnicity.

Methods:  One hundred twelve patients with bronchiectasis confirmed by chest CT scan entered the study. Data from 106 patients were available for full evaluation. Clinical questionnaire, pulmonary function tests, sputum microbiology, laboratory data, and immune function testing were done. Results were analyzed by ethnicity and etiology.

Results:  Patients were 61.6% European American (EA), 26.8% African American (AA), 8.9% Hispanic American (HA), and 2.7% Asian American. A cause of bronchiectasis was determined in 93.3% of patients. In 63.2% of patients, bronchiectasis was caused by immune dysregulation, including deficiency (n = 18 [17%]), autoimmune disease (n = 33 [31.1%]), hematologic malignancy (n = 15 [14.2%]), and allergic bronchopulmonary aspergillosis (n = 1 [0.9%]). Rheumatoid arthritis was the cause of bronchiectasis in 28.6% of AA patients vs 6.2% of EA patients (P < .05). Hematologic malignancy was the etiology in 20.0% of the EA patients vs none of the AA patients (P = .02). A significantly higher percentage of HA patients had Pseudomonas aeruginosa in their sputum compared with AA and EA patients (P = .01).

Conclusions:  The etiology of bronchiectasis can be determined in the majority of patients in a heterogeneous US population and is most often due to immune dysregulation. Rheumatoid arthritis is more likely in AA patients than EA patients. HA patients are more likely to have P aeruginosa in their sputum.

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