The aim of a study published in BMC Pulmonary Medicine was to review chest computed tomography (CT) findings of a local cohort of children with severe asthma and to explore whether clinical or pathobiological parameters could predict CT changes.

This was a retrospective observational single center study, that enrolled all children attending the Leicester difficult asthma clinic (DAC) who underwent a chest CT from 2006-2011. In addition, eight age-matched, non-asthmatic controls were included. The 30 DAC patients (age-range 5-16 years) were sub-divided into binary groups for each abnormality identified.

The results showed that the most common abnormalities were bronchial wall thickening (BWT) and air trapping (AT) – in 80 and 60% of DAC patients. While bronchiectasis (BE) was identified in 27% of DAC patients. DAC patients with evidence of BE on CT images were older than those without BE; a positive correlation between increasing BE severity and extent with age was identified. 

Hence, abnormal CT findings were highly prevalent in the cohort of children with severe asthma, bronchiectasis being identified in approximately one third of children. Meanwhile, an alternative diagnosis did not result in a change in the clinical management.

Source: BMC Pulmonary Medicine. 2019 Jul;19: 136. doi: 10.1186/s12890-019-0900-0