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Berkjuskúlk – yfirlit

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Authors
Gunnar Guðmundsson
Gunnar Júlíusson
Issue Date
2020-07

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Bronchiectasis - a review
Citation
Gunnar Guðmundsson, Gunnar Júlíusson. Berkjuskúlk – yfirlit. Læknablaðið. 2020; 106(7-8): 352-361.
Abstract
Berkjuskúlk er sjúkdómur þar sem berkjur verða óeðlilega víðar og um er að ræða viðvarandi ástand. Þetta getur verið staðbundið eða dreift um bæði lungu. Sjúkdómurinn kemur á öllum aldri og veldur hósta með uppgangi og endurteknum sýkingum. Tíðni er hærri hjá konum og vex með aldri. Hann einkennist af endurteknum tímabilum þar sem einkenni versna mikið og gerist það oftast vegna sýkinga. Berkjuskúlk getur verið af óþekktum orsökum en getur tengst fjöldamörgum sjúkdómum bæði í lungum og utan þeirra. Sem dæmi um slíka sjúkdóma eru astmi, langvinn lungnateppa og liðagigt auk þess sem brestir í ónæmiskerfi tengjast berkjuskúlki. Þannig er sjúkdómsmynd ólík milli einstaklinga. Greining fæst með tölvusneiðmynd af lungum til viðbótar við klínísk einkenni. Uppvinnsla til að greina aðra sjúkdóma sem hafa tengsl við berkjuskúlk er mikilvæg. Í því sambandi er sögutaka, líkamsskoðun og frekari rannsóknir mikilvægar. Sjúklingar með berkjuskúlk hafa skert heilsutengd lífsgæði og styttar lífslíkur. Meðferð er fólgin í meðferð undirliggjandi sjúkdóma, sýklalyfjum og loftvegahreinsun. Lungnaendurhæfing og reglulegt eftirlit eru einnig mikilvæg. Í þessari grein verður gefið yfirlit um berkjuskúlk sem nýtist mörgum læknum í daglegu starfi því sjúkdómurinn sést víða, bæði hjá heimilislæknum, á sjúkrahúsum og utan sjúkrahúsa.
Bronchiectasis is a disease that is characterized by permanent bronchial dilation. This can be localized or diffuse in the lungs. The disease can occur at any age and causes cough, sputum production and repeated infections. It is more common in women and incidence increases with age. Bronchiectasis is characterized by repeated episodes of worsening symptoms that are usually caused by respiratory infections. The cause of bronchiectasis can be unknown but it can be caused by respiratory diseases and diseases outside the chest. Examples of such diseases are asthma, chronic obstructive pulmonary disease, rheumatoid arthritis in addition to immune deficiency. Disease profile is therefore different for each patient. Bronchiectasis is diagnosed with computerized tomography of the chest in addition to clinical symptoms. Workup to diagnose other diseases that could be causing it is therefore important. For that detailed history, physical examination and additional investigations are appropriate. Patients with bronchiectasis have decreased health related quality of life and increased mortality. Treatment focuses on treatment of underlying diseases, airway clearance and treatment of infections. Pulmonary rehabilititation is also important. Regular follow-up is important. This is a review on bronchiectasis that is intended for a spectrum of physicians, because bronchiectasis can be seen in primary care, hospitals and out of hospital.
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