Freund Ophir, Bar-Shai Amir, Alkhazov Arik, Stav Dana, Hadad Yitzhac, Perluk Tal Moshe, Sror Neta, Hirsch Ayal, Ron Yulia, Thurm Tamar, Herling Amit, Leibovitzh Haim, Maharshak Nitsan, Cohen Nathaniel Aviv
Institute of Pulmonary Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Institute of Pulmonary Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Chest. 2025 Aug;168(2):317-325. doi: 10.1016/j.chest.2025.03.014. Epub 2025 Mar 28.
Inflammatory bowel diseases (IBDs) are known to be associated with bronchiectasis (BE). However, data on patients with inflammatory bowel disease-related bronchiectasis (IBD-BE) are limited.
What are the prevalence, risk factors, and clinical characteristics of IBD-BE?
This was a single-center retrospective study including patients who visited an IBD unit at a tertiary center between 2022 and 2023. Data on prior chest CT scans were extracted. Radiologists masked to clinical data analyzed all chest CT scans for BE. The overall prevalence of IBD-BE was estimated using multiple imputation analysis. Risk factors were analyzed in the whole cohort and after matching.
A total of 1,637 patients with IBD were included, and 254 had prior chest CT scans. Of these, 30 (1.8% of the cohort) had BE. The estimated overall prevalence of IBD-BE was 5.17% (95% CI, 3.60%-8.22%). Chest cuts of available abdominal CT scans (n = 1,048) were also analyzed identifying 19 additional cases of IBD-BE, resulting in a minimal prevalence of 3%. Ulcerative colitis, prior IBD-related surgery, and extraintestinal manifestations were risk factors for IBD-BE. Of patients with chest CT scans, 63% had evidence of BE on their prior abdominal CT scans, and 70% had relevant respiratory symptoms. Despite this, most did not see a pulmonologist nor receive BE-related therapy. Clinical characteristics and outcomes were similar to patients with non-IBD-related BE.
This study shows a relatively high prevalence of IBD-BE. The low rates of BE-directed therapy and pulmonology referral indicate the need for a higher degree of suspicion and timely referral.
已知炎症性肠病（IBD）与支气管扩张（BE）有关。然而，关于炎症性肠病相关支气管扩张（IBD - BE）患者的数据有限。
IBD - BE的患病率、危险因素和临床特征是什么？
这是一项单中心回顾性研究，纳入了2022年至2023年间在三级中心的IBD科室就诊的患者。提取了既往胸部CT扫描的数据。对临床数据不知情的放射科医生分析所有胸部CT扫描以确定是否存在BE。使用多重填补分析估计IBD - BE的总体患病率。在整个队列以及匹配后分析危险因素。
共纳入1637例IBD患者，其中254例有既往胸部CT扫描。其中，30例（占队列的1.8%）有BE。IBD - BE的估计总体患病率为5.17%（95%可信区间，3.60% - 8.22%）。还分析了可用腹部CT扫描（n = 1048）的胸部切片，发现另外19例IBD - BE病例，最低患病率为3%。溃疡性结肠炎、既往IBD相关手术和肠外表现是IBD - BE的危险因素。在进行胸部CT扫描的患者中，63%在其既往腹部CT扫描中有BE证据，70%有相关呼吸道症状。尽管如此，大多数患者未看肺科医生，也未接受BE相关治疗。临床特征和结局与非IBD相关BE患者相似。
本研究显示IBD - BE的患病率相对较高。BE针对性治疗和肺科转诊率低表明需要更高程度的怀疑和及时转诊。
