Aetiological Pattern of Haemoptysis in a Tertiary Level Hospital in Bangladesh

Rahman, Mohammed Tanjimur; Khan, Mmr; Tarik, Mohammad Hasan; Алим, М. А.; Rashid, Mohd Harun Or; Chowdhury, M M H; Mahmood, Iftekhar; Azhar, Muhammad Rizwan

doi:10.3329/taj.v22i1.5015

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“…The same view is endorsed in several other studies. (1,2,3,4,5,6,7,8,9,10) Like in several studies, we had a male preponderance among the patients presenting with haemoptysis. Shantikumar Singh et al (11) found Paragonimiasis as an important cause of haemoptysis in North-East India.…”

Section: Discussionsupporting

confidence: 78%

Study of Patients Presenting With Haemoptysis to Tertiary Care Centre

Rachakonda¹,

Nagasree²,

Kalyankumar³

2017

jemds

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BACKGROUND Context-We have chosen 216 patients presenting with a chief complaint of haemoptysis attending our tertiary care unit both mild, moderate and severe in our prospective study from 2013 to 2016. Aim-To study patients of haemoptysis including their age, sex distribution, background disease, severity of haemoptysis, smoking status, active disease existing and method of treatment. Settings and Design-We have taken up patients with the complaint of haemoptysis analysed history and did thorough Physical examination. MATERIALS AND METHODS A total of 216 patients presented with haemoptysis above 20 years of age were included in our study. Investigated these patients with chest x-ray and sputum for AFB. CT scan chest, bronchoscopy were done in selective patients. Smoking history was taken from all the patients, both male and female after taking consent from the Ethical Committee. Majority of the patients were subjected to conservative management. Glue therapy and Bronchial artery embolisation were required for 6 patients. RESULTS Among 216 patients admitted in the prospective study, maximum number of patients were seen in 30-49 years' group. Males outnumbered females in our study. Pulmonary tuberculosis both acute and old inactive tuberculous residual lesions are responsible for haemoptysis in nearly 60% of patients; 9.2% cases had bronchiectasis. Nearly 10% of patients came for streaky haemoptysis secondary to acute pharyngitis. Iatrogenic haemoptysis secondary to pulmonary procedures occurred in 3.24%. Post bronchoscopy procedures are an important cause of significant haemoptysis in 6.10%. Post procedural haemoptysis was always self-limiting and never life-threatening in our study. Among TB patients, active tuberculosis is responsible for haemoptysis in 25.92% among new cases of TB, followed by old inactive TB (19.9%), Defaulters (9.72%), Relapse after successful treatment (3.24%) and MDR TB (0.92%). Haemoptysis in our study group was mild in a majority (< 100 mL/day), moderate (100-300 mL/day) in only 9 patients and severe (> 300 mL/day) in only 4 patients. Most of the patients were managed only conservatively. Only six patients required intervention in the form of cyanoacrylate glue bronchoscopically and only three patients were subjected to bronchial artery embolism. CONCLUSION Haemoptysis is an alarming symptom both to the patient and the physician. Tuberculosis old and active is an important cause of haemoptysis in India. URTI, acute pharyngitis, bronchiectasis, chronic bronchitis and lung tumours and cancer are important causes of haemoptysis. Haemoptysis is mild in a large number of patients. Glue therapy and bronchial artery embolisation were required for 6 patients. Majority of the patients were managed conservatively; 10% required ICU admission.

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