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Bronchial hyperreactivity in patients with endobronchial tuberculosis
1Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Korea.
Respiratory Medicine
|July 1, 1995
Summary
Endobronchial tuberculosis (EBTB) can mimic asthma symptoms like wheezing, but patients with EBTB show normal airway responsiveness to histamine. This suggests EBTB should be considered in asthma differential diagnosis when airway reactivity is normal.
Area of Science:
- Pulmonology
- Infectious Diseases
- Respiratory Medicine
Background:
- Some patients with endobronchial tuberculosis (EBTB) present with wheezing and normal chest X-rays, mimicking bronchial asthma.
- Bronchial hyperreactivity, confirmed by challenge tests, is a hallmark of bronchial asthma.
Purpose of the Study:
- To evaluate the impact of endobronchial tuberculous inflammation on bronchial responsiveness to histamine.
- To compare histamine provocation concentrations (PC20) between EBTB patients, asthma patients, and healthy controls.
Main Methods:
- Histamine provocation tests were performed to determine the concentration causing a 20% drop in FEV1 (PC20).
- PC20 values were compared across three groups: EBTB patients, bronchial asthma patients, and healthy controls.
Main Results:
- PC20 values were significantly higher in EBTB patients and normal controls compared to bronchial asthma patients.
- No significant difference in PC20 was observed between EBTB patients and healthy controls.
- EBTB disease location and severity (FVC, FEV1) did not correlate with PC20.
Conclusions:
- Endobronchial tuberculosis can present with symptoms that mimic asthma but exhibit normal airway responsiveness.
- Histamine challenge tests may help differentiate EBTB from bronchial asthma in wheezy patients with normal airway reactivity.
- Consider EBTB in the differential diagnosis of asthma, especially when airway responsiveness appears normal.