Clinical Characteristics of Patients with Post-Tuberculosis Bronchiectasis: Findings from the KMBARC Registry

Choi, Hayoung; Lee, Hyun; Won, Seung; Kim, Hyun Kuk; Lee, Jae Seung; Um, Soo-Jung; Kim, Sang‐Heon; Oh, Yeon‐Mok; Kwon, Yong-Soo

doi:10.3390/jcm10194542

Cited by 18 publications

(11 citation statements)

References 33 publications

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“…The Korean Multicentre Bronchiectasis Audit and Research Collaboration (KMBARC) showed that 19.7% had post-tubercular bronchiectasis and a more severe radiological extent. In this registry 65.7% post-TB bronchiectasis group had obstructive airway disease and lower FEV1 than other groups [19]. Our study also showed that 55% post-tuberculosis bronchiectasis group had obstructive airway disease followed by restrictive and mixed patterns in 25% and 15%, respectively.…”

Section: Discussionsupporting

confidence: 59%

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Clinical, Radiological, and Lung Function Characteristics of Post-tuberculosis Bronchiectasis: An Experience From a Tertiary Care Center in India

Bajpai¹,

Kant²,

Verma³

et al. 2023

Cureus

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IntroductionAmong chronic respiratory diseases, bronchiectasis is one of the important causes of mortality and morbidity in developing countries. ObjectiveThis study aimed to assess the clinical, radiological, microbiological, and pulmonary function profiles of adult patients with post-tubercular bronchiectasis. MethodsWe enrolled 138 patients with bronchiectasis confirmed by high-resolution CT scans from July 2017 to August 2018. ResultsA total of 138 patients with bronchiectasis were enrolled. The data from 132 patients were analyzed; six patients were excluded from the study. The mean age of post-TB bronchiectasis (post-tuberculosis bronchiectasis) patients was 36.08±13.08, which was lower than the non-tuberculosis bronchiectasis group. The proportion of the male population was more in the post-TB bronchiectasis group (54.55% vs. 37.88%, p=0.48). Smoking prevalence was high in post-TB bronchiectasis (27.27% vs. 12.12%, p=0.04). The predominant symptom was cough in the post-tubercular bronchiectasis group (48.5% vs. 41.7%, p=0.019). The history of the recurrent common cold was seen most frequently in non-post-tubercular bronchiectasis (40.9% vs. 12.9%, p=0.001). The most common radiological variant of bronchiectasis found in all patients was a cystic type (75%). The most common site of involvement was the left lower lobe, followed by the lingula in all patients and post-tuberculosis bronchiectasis patients. Pulmonary function on spirometry revealed obstructive, restrictive, and mixed patterns in 55%, 25%, and 15%, respectively. Patients with posttuberculosis bronchiectasis had lower lung function post-FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio (70.31±15.56 vs. 76.85±11.82, p=0.015). Binary multivariate logistic regression analysis showed that only recurrent cough cold was a significant independent risk factor for post-TB bronchiectasis. ConclusionPost-tuberculosis, and bronchiectasis followed by post-infectious causes, were the most common causes of bronchiectasis and poor lung function.

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Section: Discussionsupporting

confidence: 59%

“…19.4%) of the post-tubercular patients, followed by Staphylococcus aureus (9; 13.9%), Acinetobacter sp., (4; 6.9%), Hemophilus influenza (3; 4.2%). The comparison of lung function between the two groups showed that mean FEV1 pre, FEV1 post, FVC pre, and FVC post were not significantly different between groups.…”

mentioning

confidence: 99%

Clinical, Radiological, and Lung Function Characteristics of Post-tuberculosis Bronchiectasis: An Experience From a Tertiary Care Center in India

Bajpai¹,

Kant²,

Verma³

et al. 2023

Cureus

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“…The decline in FEV1 was attributed to chronic colonization with nontuberculous pathogens, biomass fuel exposure, and poor nutrition [52 ▪▪ ]. In another study, individuals with PTLD and bronchiectasis had a higher risk of infection with atypical mycobacterial pathogens and lower FEV1/FVC ratio than other causes of bronchiectasis [53].…”

Section: Mechanism Of Progression Of Parenchymal and Spirometric Abno...mentioning

confidence: 99%

Burden, clinical features, and outcomes of post-tuberculosis chronic obstructive lung diseases

Sehgal,

Dhooria,

Muthu

et al. 2023

Current Opinion in Pulmonary Medicine

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Purpose of review Post-tuberculosis lung disease (PTLD) is an increasingly recognized and debilitating consequence of pulmonary tuberculosis (PTB). In this review, we provide a comprehensive overview of PTLD with airflow obstruction (PTLD-AFO), focusing on its burden, pathophysiology, clinical manifestations, diagnostic methods, and management strategies. Recent findings The relationship between PTLD and airflow obstruction is complex and multifactorial. Approximately 60% of the patients with PTLD have some spirometric abnormality. Obstruction is documented in 18–22% of PTLD patients. The host susceptibility and host response to mycobacterium drive the pathogenic mechanism of PTLD. A balance between inflammatory, anti-inflammatory, and fibrotic pathways decides whether an individual with PTB would have PTLD after microbiological cure. An obstructive abnormality in PTLD-AFO is primarily due to destruction of bronchial walls, aberrant healing, and reduction of mucosal glands. The most common finding on computed tomography (CT) of thorax in patients with PTLD-AFO is bronchiectasis and cavitation. Therefore, the ‘Cole's vicious vortex’ described in bronchiectasis applies to PTLD. A multidisciplinary approach is required for diagnosis and treatment. The disability-adjusted life-years (DALYs) attributed to PTLD represent about 50% of the total estimated burden of DALYs due to tuberculosis (TB). Patients with PTLD require comprehensive care that includes psychosocial support, pulmonary rehabilitation, and vaccination against respiratory pathogens. In the absence of trials evaluating different treatments for PTLD-AFO, therapy is primarily symptomatic. Summary PTLD with airflow obstruction has considerable burden and causes a significant morbidity and mortality. However, many aspects of PTLD-AFO still need to be answered. Studies are required to evaluate different phenotypes, especially concerning Aspergillus-related complications. The treatment should be personalized based on the predominant phenotype of airflow obstruction. Extensive studies to understand the exact burden, pathogenesis, and treatment of PTBLD-AFO are needed.

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“…Connective tissue disease is a common comorbidity of bronchiectasis, accounting for 12% of patients with bronchiectasis in a European cohort and 6% of those in a cohort from Korea ( 2 , 4 ). Rheumatoid arthritis (RA) is one of the most common autoimmune diseases associated with bronchiectasis ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and prognostic factors of bronchiectasis rheumatoid overlap syndrome: A multi-institution cohort study

et al. 2022

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The information regarding bronchiectasis with RA (BROS) is limited in Asia. The objective of this study was to investigate the clinical characteristics and outcomes of BROS in Taiwan. This multi-institute cohort study included patients with BROS from January 2006 to December 2017. The clinical, functional and microbiological data of these patients were retrieved from the Chang Gung Research Database. Respiratory failure and mortality were the primary outcomes. Severe exacerbation was defined as bronchiectasis- related hospitalizations or emergency department visits. A total of 343 patients with BROS were identified. One hundred and eight patients had severe exacerbation and exhibited significantly more previous exacerbations, a lower FEV1 and higher BACI score (11.1 vs. 7.5) than patients without severe exacerbation. The most prevalent species in sputum were Non-tuberculous mycobacteria (NTM) (14.8 %), Pseudomonas aeruginosa (14.2 %), and fungus (5.9%). 68.8% of BROS patients used disease modifying antirheumatic drugs (DMARD), 7.9% used biological DMARD. NTM and tuberculosis infection rates were higher in bDMARD group compared with nbDMARD group and others. Overall, the 3-year respiratory failure rate and mortality rate were 14.6 and 25.7% respectively. Patients with RA diagnosed before bronchiectasis had a significantly higher cumulative incidence of mortality in a 3-year follow-up than those with RA diagnosed after bronchiectasis. In Cox regression, age, higher RF value and systemic steroid use were independent risk factors for mortality in BROS. BROS patients with severe exacerbation had a high mortality rate in Taiwan. bDMARD is associated with a trend of increased risk of NTM and TB infections.

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Clinical Characteristics of Patients with Post-Tuberculosis Bronchiectasis: Findings from the KMBARC Registry

Cited by 18 publications

References 33 publications

Clinical, Radiological, and Lung Function Characteristics of Post-tuberculosis Bronchiectasis: An Experience From a Tertiary Care Center in India

Clinical, Radiological, and Lung Function Characteristics of Post-tuberculosis Bronchiectasis: An Experience From a Tertiary Care Center in India

Burden, clinical features, and outcomes of post-tuberculosis chronic obstructive lung diseases

Clinical outcomes and prognostic factors of bronchiectasis rheumatoid overlap syndrome: A multi-institution cohort study

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