Pulmonary tuberculosis: the day after

Akkara, Stani Ajay; Shah, Arti; Adalja, Mayur; Akkara, Ajay George; Rathi, Akanksha; Shah, DA

doi:10.5588/ijtld.12.0317

Cited by 38 publications

(51 citation statements)

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“…The fact that the presence of ventilatory restriction, as measured by a reduced forced vital capacity (FVC) is an important predictor of mortality among COPD patients 54 could have implications for TB patients who have combined restrictive and obstructive lung function deficits. This is supported by studies from TB endemic countries such as South Africa, Romania, Pakistan, India, Korea and Brazil that have characterised the patterns of lung function loss that exist among pulmonary TB patients 50,51,[55][56][57][58] . Abnormal lung function, as measured by spirometry, associated with pulmonary TB was observed in between 18-94% of patients.…”

Section: Discussionmentioning

confidence: 90%

Tuberculosis and chronic respiratory disease: a systematic review

Byrne

Marais

Mitnick

et al. 2015

International Journal of Infectious Diseases

275

237

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Section: Discussionmentioning

confidence: 90%

Tuberculosis and chronic respiratory disease: a systematic review

Byrne

Marais

Mitnick

et al. 2015

International Journal of Infectious Diseases

275

237

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“…However, those studies did not assess the severity of spirometric changes. (13,15,32,(34)(35)(36) Disease overlap could explain the higher frequency of symptoms (dyspnea, cough, expectoration, and wheezing) in the LDS+ group. Some limitations of the present study should be noted.…”

Section: Discussionmentioning

confidence: 99%

Spirometry results after treatment for pulmonary tuberculosis: comparison between patients with and without previous lung disease: a multicenter study

Mancuzo¹,

Netto²,

Sulmonett³

et al. 2020

J Bras Pneumol.

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Objective: To compare patients with and without previous lung disease, in terms of the spirometry results after they had been treated for pulmonary tuberculosis (PTB) and cured, as well as to analyze risk factors related to functional severity. Methods: This was a cross-sectional, multicenter study conducted at four referral centers in Brazil. Patients were divided into two groups: those with a history of lung disease or smoking (LDS+ group); and those with no such history (LDS− group). Patients underwent spirometry (at least six months after being cured). Sociodemographic and clinical data were collected. Results:A total of 378 patients were included: 174 (46.1%) in the LDS+ group and 204 (53.9%) in the LDS− group. In the sample as a whole, 238 patients (62.7%) had spirometric changes. In the LDS+ group, there was a predominance of obstructive lung disease (in 33.3%), whereas restrictive lung disease predominated in the LDS− group (in 24.7%). Radiological changes were less common in the LDS− group than in the LDS+ group (p < 0.01), as were functional changes (p < 0.05). However, of the 140 (79.1%) LDS− group patients with a normal or minimally altered chest X-ray, 76 (54%) had functional changes (p < 0.01). The risk factors associated with functional severity in the LDS− group were degree of dyspnea (p = 0.03) and moderate or severe radiological changes (p = 0.01). Conclusions: Impaired pulmonary function is common after treatment for PTB, regardless of the history of lung disease or smoking. Spirometry should be suggested for patients who develop moderate/severe dyspnea or relevant radiological changes after treatment for PTB.

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“…Obstructive defects were also more common in studies by Akkara et al . [8] and Menezes et al . [16] Thus, while abnormal spirometric values are common even after successful completion of TB treatment, the type of defect is variable due to variation in disease extent and patient selection criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Such patients present with varying severity of dyspnea, hemoptysis, pulmonary artery hypertension (PAH), or recurrent secondary infections; and are often treated with antitubercular therapy repeatedly. [5678] Hence, sequelae of pulmonary TB constitute a large burden on the public health system.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae

et al. 2016

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Aims:To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs) in patients with sequelae of pulmonary tuberculosis (TB).Materials and Methods:Clinical history, chest computed tomography (CT), and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC) scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma. Semi-quantitative analysis was done for these abnormalities. Scores were added to obtain a total morphological score (TMS). The lungs were also divided into three zones and scores added to obtain the total lung score (TLS). Spirometry was done for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC.Results:Dyspnea was present in 58/101 patients. A total of 22/58 patients had mMRC Grade 1, and 17/58 patients had Grades 2 and 3 dyspnea each. There was a significant difference in median fibrosis, bronchiectasis, nodules (P < 0.01) scores, TMS, and TLS (P < 0.0001) between dyspnea and nondyspnea groups. Significant correlations were obtained between grades of dyspnea and fibrosis (r = 0.34, P = 0.006), bronchiectasis (r = 0.35, P = 0.004), nodule (r = 0.24, P = 0.016) scores, TMS (r = 0.398, P = 0.000), and TLS (r = 0.35, P = 0.0003). PFTs were impaired in 78/101 (77.2%) patients. Restrictive defect was most common in 39.6% followed by mixed in 34.7%. There was a negative but statistically insignificant trend between PFT and fibrosis, bronchiectasis, nodule scores, TMS, and TLS. However, there were significant differences in median fibrosis, cavitation, and bronchiectasis scores in patients with normal, mild to moderate, and severe respiratory defects. No difference was seen in TMS and TLS according to the severity of the respiratory defect.Conclusion:Both fibrosis and bronchiectasis correlated with dyspnea and with PFT. However, this correlation was not linear. The overall extent of radiological abnormalities correlated only with dyspnea but not with PFT.

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Pulmonary tuberculosis: the day after

Abstract: PTB patients need long-term follow-up to diagnose and treat functional impairment after cure.

Cited by 38 publications

References 0 publications

Tuberculosis and chronic respiratory disease: a systematic review

Tuberculosis and chronic respiratory disease: a systematic review

Spirometry results after treatment for pulmonary tuberculosis: comparison between patients with and without previous lung disease: a multicenter study

Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae

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