Reversal of bronchiectasis caused by chronic aspiration in cri du chat syndrome.

Bronchiectasis is a chronic lung disease whose pathophysiology is poorly understood. It has traditionally been considered “permanent and irreversible”. In addition to chronic airway inflammation and infection, chronic aspiration has been implicated as another aetiological possibility. We recently cared for a Samoan child with cri du chat syndrome, admitted four times with wheezing before 15 months of age. He had persistent central and peripheral type wheezing and digital clubbing. A modified barium swallow revealed mild dysfunction of the oral phase of swallowing. A nuclear scintiscan revealed eight episodes of gastro-oesophageal reflux. Chest radiograph revealed bibasilar reticulonodular opacities with new right middle lobe disease (fig 1). High resolution computed tomography