From the Guidelines
Bronchiectasis patients should undergo a panel of investigations including full blood count, serum total IgE, assessment of sensitisation to A. fumigatus, serum IgG, IgA, and IgM, and sputum cultures for routine and mycobacterial culture, as recommended by the British Thoracic Society guideline for bronchiectasis in adults 1. The following laboratory tests are indicated for bronchiectasis:
- Full blood count to assess for infection and inflammation
- Serum total IgE and assessment of sensitisation to A. fumigatus to identify allergic bronchopulmonary aspergillosis
- Serum IgG, IgA, and IgM to check for immunodeficiency
- Sputum cultures to identify pathogens and guide antibiotic therapy
- Testing for cystic fibrosis and primary ciliary dyskinesia in patients with supporting clinical features Additional tests may be appropriate in response to specific clinical features, or in patients with severe or rapidly progressive disease, as suggested by the European Respiratory Society guidelines for the management of adult bronchiectasis 1. It is essential to note that the minimum bundle of aetiological tests in adults with a new diagnosis of bronchiectasis includes differential blood count, serum immunoglobulins, and testing for allergic bronchopulmonary aspergillosis, as recommended by the European Respiratory Society guidelines 1. Regular monitoring of these parameters helps track disease progression and treatment effectiveness, and is crucial for appropriate management of bronchiectasis, as highlighted by the British Thoracic Society guideline 1.
From the Research
Laboratory Tests for Bronchiectasis
The following laboratory tests are indicated for bronchiectasis:
- Immunoglobulins: to identify underlying immunodeficiency conditions 2
- Testing for allergic bronchopulmonary aspergillosis: to diagnose this condition, which can cause bronchiectasis 2
- Full blood count: to detect any underlying infections or inflammatory conditions 2
- Microbiological tests: to identify the presence of pathogens such as Pseudomonas aeruginosa, which can cause airway infection and contribute to disease progression 3, 4
Additional Testing
Additional testing may be recommended based on the clinical history, radiological features, and severity of disease, including:
- High-resolution computed tomography (HRCT) scans: to detect the underlying causes of bronchiectasis and identify any complications 2
- Molecular diagnostics: to improve diagnostic accuracy and detect the presence of specific pathogens 4
- Biomarkers: to monitor disease progression and response to treatment 4