DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20164197

Chronic airway obstruction in post tubercular fibrosis cases:a serious lung function changes

Abinash Agarwala, Malay Kumar Maikap, Prabodh Panchadhyayee, Pranab Mandal, Partha Pratim Roy

Abstract


Background: Tuberculosis (TB) is a major cause of death worldwide. About two thirds of patients develop impaired pulmonary function after completion of pulmonary tuberculosis treatment. But data is lacking to support this assertion. Objective of the study was to determine the frequency of chronic obstructive pulmonary disease (COPD) in post tubercular fibrosis patients in the hospital.

Methods: This is a cross-sectional study which was done at Medinipore Medical College & Hospital in post tubercular fibrosis patients from August 2015 to July 2016. 72 patients who had post tubercular fibrosis were included for spirometry test. Those having a probability of re-activated TB, having history of current or previous smoking or occupational exposure, asthmatics and cases of interstitial lung disease and ischemic heart disease were excluded. Pre- and post-dilator FVC, FEV1 and FEV1/FVC were recorded in each case through simple spirometry.

Results: There were 83.3% (n=72) males. Thirty eight (52.7%) were found to have an obstructive ventilatory defect of different degrees: severe/stage III in 63.1% (n=24), moderate/stage II in 21.5%% (n=8) and mild/stage I in 15.7 % (n=6). Ten (13.8) were found to have a restrictive pattern and 12 (16.6%) revealed a mixed obstructive and restrictive pattern. Only 12 patients (16.6%) had normal lung function. Among the 38 patients with obstruction in spirometry, 24 patients (63.2%) were under weight.

Conclusions: Chronic obstructive pulmonary disease can occur as one of the chronic complications of pulmonary tuberculosis and the obstructive ventilatory defect appears more common especially in patients with low BMI.


Keywords


COPD, Obstructive pulmonary ventilatory defect, Pulmonary function tests, Restrictive ventilatory defect, Tuberculosis

Full Text:

PDF

References


Lopez AD, Mathers CD, Ezzali M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors 2001: systemic analysis of population health data. Lancet. 2006;367:1747-57.

Jung KH, Kim SJ, Shin C, Kim JH. The considerable, often neglected, impact of pulmonary tuberculosis on the prevalence of COPD. Am J Respir Crit Care Med. 2008; 178:431.

Macnee W. Chronic Bronchitis and Emphysema: Seaton A, Seaton D, Leitch AG. Crofton and Douglas's Respiratory Disease, United Kingdom: Blackwell Science. 2002;616-7.

Leitch AG. Pulmonary tuberculosis: Clinical features in: Seaton A, Seaton D, Leitch AG, editors. Crofton and Douglass's Respiratory Disease, United Kingdom. Blackwell science. 2002;523.

Snider GL, Doctor L, Demas TA, Shaw AR. Obstructive airway disease in patients with treated pulmonary tuberculosis. Am Rev Respir Dis. 1971;103:625-40.

Lee JH, Chang JH. Lung functions in patients with chronic airflow obstruction due to tuberculous destroyed lung. Respir Med. 2003;97:1237-42.

Patricio Jimenez P, Vivianne Torres G, Paula Lehmann F, Elisa Hernandez C, Mauricio Alvarez M, Monica Meneses M, et al. Chronic airways obstruction in patients with tuberculosis sequel: a comparison with COPD. Rev Chil Enf Respir. 2006;22:98-104.

Menezes AMB, Hallal PC, Perez-Padilla R, Jardim JRM, Muin OA, Lopez MV, et al. Latin American Project for the investigation of obstructive lung disease (PLATINO) team. Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America. Eur Respir J. 2007;30:1180-5.

Verma SK, Narayan KV, Kumar S. A study on prevalence of obstructive airway disease among post pulmonary tuberculosis patients. Pulmon. 2009;11(1):4-7.

Romagnani S. Lymphocyte production by Human T-cells in disease states. Ann Rev Immunol. 1994;12: 227.

Romagnani S. Role of the Th2 lymphocytes in the genesis of allergic disorders and mechanics involved in their development in Holgate S.T et al. (eds). Asthma: Physiology Immunopathology and treatment Academic Press, London. 1993.

Holgate S. Mediator and cytokine mechanisms in asthma. Thorax. 1993;48:103.

Nefedov VB, Smirnova DG, Disorders of pulmonary functionin patients with destructive tuberculosis. Probl Tuberk. 1991;11:51-4.

Vargha and fifteen years follow up of lung function in obstructive and non-obstructive pulmonary tuberculosis. Acta Med Hung. 1983;40:271-6.

Macnee W, chronic bronchitis and emphysema, Seaton A Seaton D, Leitch AG Crofton Douglas Respiratory Diseases, United Kingdom; Black well science. 2002;616-7.

Leitch AG Pulmonary tuberculosis Clinical features in; Seaton ASeaton D Leitch AG Editor Crofton Douglass's Respiratory diseas, United Kingdom: Black Well sciences. 2002;523.

Hassan IS, Al-jandali HH, Obstructive airway disease in patients with significant post TB lung scarring. Saudi Med J. 2005:26;1155-7.

Salvi SS, Barness PJ. Chronic obstructive pulmonary disease in non-smokers Lancet. 2009;374:733-43.