Clinico-Radiologic and Spirometric Profile of an Indian Population with Post-Tuberculous Obstructive Airway Disease

Tuberculosis is a public health problem in developing countries and in spite of receiving adequate anti-tuberculous therapy, patients often continues to have several post-tuberculous sequelae, especially airflow limitation.

To evaluate pulmonary function by spirometry among post-tuberculosis cases with airway obstruction and their relationship with smoking.

All patients who presented to the pulmonary medicine Outpatient Department (OPD) with symptoms of obstructive airway disease and had completed adequate anti-tuberculous therapy for pulmonary tuberculosis were taken up for study. They were initially evaluated with sputum smear for Acid Fast Bacilli (AFB) and chest X-ray. Patients without evidence of active tuberculosis underwent spirometry and those having post-bronchodilator Forced Expiratory Volume in first second (FEV1)/ Forced Vital Capacity (FVC) FEV1/FVC<0.7 were taken up for final analysis. Spirometric parameters were compared between smokers and non-smokers.

Out of 138 finally selected cases, 84.06% were male and 71.01% were within age range of 40-69 years. Significant positive association was found between extent of radiologic lesion and severity of airflow obstruction. Purely obstructive pattern was found in 27.54% cases and 72.46% showed mixed pattern. Patients with mixed ventilatory abnormality had worse pulmonary function and poorer bronchodilator reversibility than patients with pure obstruction. Comparison of post-bronchodilator FEV1, FVC, Peak Expiratory Flow (PEF) and Forced Expiratory Flow (FEF) 25-75 between smokers and non-smokers did not show statistically significant difference.

Majority of patients with post-tuberculous obstructive airway disease have associated restrictive component. But smoking did not cause significant alteration in pulmonary function among such patients.