Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 109219, 7 pages http://dx.doi.org/10.1155/2013/109219 Clinical Study Prevalence of Bronchiectasis in Asthma according to Oral Steroid Requirement: Influence of Immunoglobulin Levels Manel Luján, 1,2,3 Xavier Gallardo, 4 María José Amengual, 5 Montserrat Bosque, 6 Rosa M. Mirapeix, 7 and Christian Domingo 1,2 1 Servei de Pneumologia, Hospital de Sabadell, Corporaci´ o Sanit` aria i Universit` aria Parc Taul´ ı, Parc Taul´ ı 1, Sabadell, 08208 Barcelona, Spain 2 Departament de Medicina, Universitat Aut` onoma de Barcelona (UAB), Campus de la UAB, Cerdanyola del Vall` es, 08193 Barcelona, Spain 3 Ciber de Enfermedades Respiratorias (CIBERES), Carretera Soller Km 12, Illes Balears, 07110 Bunyola, Spain 4 Servei de Diagn` ostic per la Imatge, UDIAT, Corporaci´ o Sanit` aria i Universit` aria Parc Taul´ ı, Parc Taul´ ı 1, Sabadell, 08208 Barcelona, Spain 5 Servei de Laboratori, UDIAT, Corporaci´ o Sanit` aria i Universit` aria Parc Taul´ ı, Parc Taul´ ı 1, Sabadell, 08208 Barcelona, Spain 6 Servei de Pediatria, Unitat de Pneumologia, Al.l` ergia i Fibrosi Qu´ ıstica, UDIAT, Corporaci´ o Sanit` aria i Universit` aria Parc Taul´ ı, Parc Taul´ ı 1, Sabadell, 08208 Barcelona, Spain 7 Departament de Ci` encies Morfol` ogiques, Universitat Aut` onoma de Barcelona (UAB), Campus de la UAB, Cerdanyola del Vall` es, 08193 Barcelona, Spain Correspondence should be addressed to Christian Domingo; cdomingo@tauli.cat Received 3 June 2013; Revised 1 October 2013; Accepted 1 October 2013 Academic Editor: Edineia Lemos Andrade Copyright © 2013 Manel Luj´ an et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To establish the prevalence of bronchiectasis in asthma in relation to patients’ oral corticosteroid requirements and to explore whether the increased risk is due to blood immunoglobulin (Ig) concentration. Methods. Case-control cross-sectional study, including 100 sex- and age-matched patients, 50 with non-steroid-dependent asthma (NSDA) and 50 with steroid-dependent asthma (SDA). Study protocol: (a) measurement of Ig and gG subclass concentration; (b) forced spirometry; and (c) high-resolution thoracic computed tomography. When bronchiectasis was detected, a speciic etiological protocol was applied to establish its etiology. Results. he overall prevalence of bronchiectasis was 12/50 in the SDA group and 6/50 in the NSDA group (= ns). he etiology was documented in six patients (four NSDA and two SDA). Ater excluding these patients, the prevalence of bronchiectasis was 20% (10/50) in the SDA group and 2/50 (4%) in the NSDA group ( < 0.05). Patients with asthma-associated bronchiectasis presented lower FEV 1 values than patients without bronchiectasis, but the levels of Ig and subclasses of IgG did not present diferences. Conclusions. Steroid-dependent asthma seems to be associated with a greater risk of developing bronchiectasis than non-steroid-dependent asthma. his is probably due to the disease itself rather than to other inluencing factors such as immunoglobulin levels. 1. Introduction Bronchiectasis is deined as abnormal, irreversible thick- walled dilatation of the bronchi and represents the end stage of a variety of pathological processes. Caused by the inlam- matory reaction of the bronchi and their frequent chronic bacterial colonization, bronchiectasis usually presents with recurrent lower respiratory tract infections and chronic mucopurulent sputum production. Bronchiectasis oten goes unrecognized, even when char- acteristic features are present and appropriate diagnostic techniques are readily available. In a recent study the etiology of the condition was identiied in only 57% of patients [1]. he etiological spectrum of the disease has changed notably since it was irst described. In the preantibiotic era, bronchiectasis was almost exclusively due to untreated or suboptimally treated lung infections, including pneumonia or tuberculosis [2]. Today, although the majority of identiied causes of