R. Ramakrishna1, P. V. Kalyan Kumar2
BACKGROUND
We studied patients of COPD and analysed their past history of Pulmonary tuberculosis. Sixty patients of post tubercular bronchiectasis were analysed. In the third study we studied the association of bronchiectasis among patients diagnosed as COPD. The study was conducted in our tertiary care centre from 2011 to 2014.
METHODS
In the first study we analysed the history of Pulmonary Tuberculosis among the COPD patients above 30 years’ age diagnosed with clinical, radiological, spirometric analysis along with routine sputum and haematological examination.
In the second study 60 cases of Post tubercular bronchiectasis were analysed for Male: Female ratio, comorbidities, type of bronchiectasis and symptoms.
In the third study we analysed 50 patients of COPD diagnosed with symptomatology and spirometry and subjected them to clinical, radiological (Chest X-ray, CT scan), serum albumin levels and microbiological examination by sending for sputum culture.
We correlated all the three studies and analysed the results.
RESULTS
In this study we found that 57% of patients diagnosed to have chronic obstructive pulmonary disease by clinical examination and spirometry were found to have a history of tuberculosis treatment. Post tubercular obstructive airway disease was more common in males (Male: female ratio 48:9). Among the males all but one were smokers. 36 of 47 male smokers had a smoking index of more than hundred. Among the 9 female patients only one was a limited smoker and all of them were passive smokers and exposed to biological fuel. Among sixty patients of post tubercular bronchiectasis Male: Female ratio was 58:42. More than 50% of these patients were smokers. Among these cases of post tubercular bronchiectasis 28% had chronic obstructive pulmonary disease as comorbidity. In our analysis of 50 cases of moderate to severe chronic obstructive airway disease we found 60% of them had associated bronchiectasis by HRCT. Mean age of these patients of bronchiectasis associated with COPD was 63±7 with male preponderance of 9:1. This combination of patients had more exacerbations, less serum albumin levels and more mortality.
CONCLUSIONS
Majority of patients diagnosed to have COPD gave history of Tuberculosis. Tuberculosis is an important cause of pulmonary fibrosis and COPD like illness. Tuberculosis induced pulmonary fibrosis and tubercular airway disease leads to bronchiectasis. COPD is associated with bronchiectasis in a number of patients. COPD patients are prone to develop Pulmonary tuberculosis because of smoking and poor respiratory defences. Bronchiectasis patients have associated with COPD and are prone to Tuberculosis infection. The three diseases present in variable proportion in patients and cause considerable morbidity and mortality and increase cost of treatment. Early treatment of Tuberculosis and Prevention of smoking can prevent these complications.
