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Airflow limitation due to COPD despite tuberculosis sequellae

Nawel Ben Salem, Nawel Chaouch, Manel Loukil, Mourad Zarrouk, Sana Cheikh Rouhou, Hajer Racil, Khaoula Ben Miled, Abdellatif Chabbou
European Respiratory Journal 2011 38: p2703; DOI:
Nawel Ben Salem
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Nawel Chaouch
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Manel Loukil
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Mourad Zarrouk
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Sana Cheikh Rouhou
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Hajer Racil
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Khaoula Ben Miled
2Radiology, A. Mami Hospital, Ariana, Tunisia
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Abdellatif Chabbou
1Pneumology, A. Mami Hospital, Research Unit IRC MSP-MESR, El Manar University, Ariana, Tunisia
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Abstract

Pulmonary (P) tuberculosis (TB) and COPD are both a significant worldwide burden in terms of morbidity and mortality. They can both induce similar respiratory symptoms and chronic air flow limitation (AFL) leading to diagnosis difficulties.

To clarify if COPD can be considered in patients with TB sequellae, we retrospectively analyzed cases of patients with AFL (FEV1/VC post bronchodilator <70%) and medical history of PTB, hospitalized between 2000 and 2010 in which diagnosis of COPD was more probable than TB sequella because of important tobacco use and clinical history. All patients underwent CT scan to precise P lesions. Patients with PTB after COPD diagnosis were excluded and those with extended PTB sequellae as well.

Fifteen patients were included. Mean age was 60 years (44-83 years). Mean smoking level was 58 pack year. The mean delay between TB history and diagnosis of COPD was 20 years. Dyspnea was present in all cases and associated to chronic cough and sputum in 87% of cases. CT scan showed besides TB sequellae, P emphysema in all cases (centrolobular in 75%). AFL was severe in 80% of cases (GOLD III and IV). Treatment was based on theophylline and/or inhaled long-acting B2 agonists in all cases. All patients had clinical improvement with bronchodilator. Outcome was marked by at least one exacerbation for 13 patients due to P embolism in 2 cases, pneumothorax in 1 case and respiratory infections in all other cases.

COPD should be considered in smokers with AFL even if they have a previous history of PTB. Despite few cases of paraseptal emphysema, the majority of these patients show predominant P centrolobular and panlobular emphysema with an outcome similar to those with COPD and no PTB history.

  • © 2011 ERS
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Airflow limitation due to COPD despite tuberculosis sequellae
Nawel Ben Salem, Nawel Chaouch, Manel Loukil, Mourad Zarrouk, Sana Cheikh Rouhou, Hajer Racil, Khaoula Ben Miled, Abdellatif Chabbou
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2703;

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Airflow limitation due to COPD despite tuberculosis sequellae
Nawel Ben Salem, Nawel Chaouch, Manel Loukil, Mourad Zarrouk, Sana Cheikh Rouhou, Hajer Racil, Khaoula Ben Miled, Abdellatif Chabbou
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2703;
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More in this TOC Section

  • Assessment of the prevalence of pulmonary involvement in cases with extrapulmonary tuberculosis
  • Pulmonary involvement in extrapulmonary tuberculosis patients
  • Pulmonary involvement in pleural tuberculosis: How often does it mean disease activity?
Show more 282. Pulmonary and extrapulmonary tuberculosis

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