الفهرس 
BronchiectasisOnly 14 pages are availabe for public view
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Abstract
Background: bronchiectasis is defined as the permanent dilatation of bronchi that results from a vicious cycle of inflammatory and infectious damage to the bronchial and bronchiolar walls. While cystic fibrosis (CF) is the most common cause of bronchiectasis in childhood in the developed world, non CF bronchiectasis is may result from a number of other conditions that include tuberculosis and pertussis squeal, immunodeficiency, connective tissue disorders and allergic bronchopulmonary aspergillosis etc. Accurate estimates of the worldwide prevalence of bronchiectasis are unavailable and further epidemiological studies are needed to better evaluate the impact of this condition in different populations. High-resolution computed tomography (HRCT) is the criterion standard investigation for assessing bronchiectasis.
Aim of the Work: to evaluate the relationship between NLR (marks of inflammation) and presence of disease (bronchiestasis and ILD) in children. Compare NLR values in stable state of the two diseases and in state of acute exacerbation.
Patients and Methods: our study included Forty (40) patients with chronic lung diseases who attended the Pediatric Chest clinic Children’s hospital in Ain Shams University hospital in the period from February 2016 until November 2017. The patients were divided into two groups: group 1: Included twenty (20) patients with non-cystic fibrosis bronchiectasis disease they were 12 (60%)female and 8(40%) male with mean age 11.25+2.3, 10 children, were in stable state (group 1A), and 10 children were in a state of acute exacerbation (Group1B). group 2: Included twenty (20) patients with interstitial lung disease, 13(65%) female and 7(35%) male with mean age 9.3+3.011, 10 children, were in stable stae (group 2A) and 10 children were in state of acute exacerbation (group 2B). group 3: Included ten (10) healthy children of equivalent age and sex, 3(30%) female and 7(70%) male with mean age 8.7+2.08, were considered as control.
Results: this study included 40 patients 20 diagnosed with Bronchiectasis, 20 diagnosed with Interstitial lung disease (ILD) and 10 control. Their mean age was 9.96 ± 2.90 years with range of 7.06 – 12.86 years. Table shows no statistical significant difference between stable and exacerbation in FVC%, FEV1/FVC ratio and Mmef% (P>0.05). But there was statistical significant difference between stable and exacerbation in FEV1% (P<0.05). There was no statistical significant difference between Group1B (bronchiectasis in acute exacerbation) and group 3 (control group) as regards TLC, ESR and absolute lymphocyte counts. But there was statistical significant difference as regards CRP, NLR and absolute Neutrophil counts (P<0.05).
Conclusion: our study suggests that NLR may be effective and usable biomarker for determining systemic inflammation in pediatric bronchiectasis and ILD cases during acute exacerbation period rather than severity of the disease and it is more sensitive than TLC, ANCs, CRP and ESR. However, a broad analysis of dependent and independent variables in further prospective studies is still required.