Association between tuberculosis and bronchial asthma

Abstract

Background: Everything that wheezes is not asthma. In patients of tuberculosis (TB), wheezing can be because of bronchial asthma, or many other causes. Asthma and other causes of wheezing need to be differentiated, as the treatment should be planned accordingly.Methods: Patients of active/quiescent tuberculosis who presented to Department of Tuberculosis and Chest Diseases, Government Medical College, Patiala, Punjab, India, with complaints of breathlessness and had rhonchi on examination were subjected to bronchodilator reversibility testing to prove if they were suffering from concomitant asthma. Patients thus found to have tuberculosis along with asthma were analyzed with respect to age, sex, rural urban differences and timing of diagnosis of either disease. Patients who developed asthma after tuberculosis were further analyzed for duration between completion of anti-tubercular treatment (ATT) and onset of asthma, family history of asthma and correlation of radiological manifestations and lung function measurements. Aim was to find association, if any, between tuberculosis and asthma.Results: Over 6 months, 69 patients of tuberculosis along with asthma were found. Only 21/69 (30.4%) patients developed tuberculosis after asthma. 48/69 (69.6%) patients developed asthma after tuberculosis. Majority (25/48=52.1%) of them developed asthma within 5 years of completion of ATT (p=0.020). Only 2/48 (2.9%) patients had a positive family history for asthma. Lung function abnormalities correlated with the extent of radiological involvement in these patients who developed asthma after tuberculosis (p ≤0.0001).Conclusions: Patients of active/quiescent tuberculosis who present with breathlessness and have rhonchi on examination should be treated for asthma only after confirmation of the diagnosis, as there can be other reasons for the same.

Incidence of Tuberculosis Among Patients of Bronchial Asthma Receiving Treatment With Metered Dose Corticosteroid by Inhalation

“…DOI: 10.18410/jebmh/2018/565 BACKGROUND Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis (MTB). [1][2][3][4][5][6][7][8][9][10][11][12][13] Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as Latent tuberculosis.…”

“…Whether use of steroids in an asthmatic causes flare up of tuberculous lesions has been a long continuing debate. [5][6][7][8][9] More than 30% of the Indian population is subclinically infected with Mycobacterium tuberculosis. Corticosteroids have been shown to affect the lymphocytes, and thereby, affecting inflammatory and immunologically mediated processes.…”

“…of reports of association between use of inhaled corticosteroids and risk of tuberculosis from both abroad and India. [5][6][7][8][9] So we thought it prudent to study its incidence in our region and evaluate the possible role of corticosteroids in causing tuberculosis in patients with bronchial asthma necessitating use of MDI therapy.…”

Exploring Tuberculosis: A Theoretical Framework for Infection Regulation and Eradication

“…The true revolution commenced a few years later, in 1952, when a drug called the first oral mycobactericidal medication, was developed. Rifampin's implementation in the 1970s sped up the healing process and, up until the 1980s, substantially reduced the number of tuberculosis cases [23][24][25][26][27][28][29][30][31][32].…”