PURPOSE: Tuberculosis can affect lung function, but no data exist on long- term follow-up. Tissue remodeling following granulomatous inflammation may underlie functional deterioration after microbiologicalresolution. We performed a long-term evaluation of lung function after diagnosis and treatment of tuberculosis.
METHODS: We studied a cohort of subjects diagnosed with pulmonary tuberculosis and treated in 1996, excluding pleurisy and concomitant disease or HIV infection. The subjects underwent pulmonary function tests, chest x-ray and blood analy- sis for IgE, α-1-antitrypsin and C reactive protein. Pulmonary function data are expressed as percentage of predicted value (mean ± standard deviation).
RESULTS: The cohort comprised 232 cases of which 155 fulfilled inclusion criteria. We recruited 54 subjects that could be located and accepted to participate, aged 44±13; 53.7% were female; 42,6% were smokers averaging 18 pack-years. FEV1 was 88,5% ± 20,6%; 17 subjects (31,5% of study sample) had FEV1 < 80% and 3 subjects (5,5%) had FEV1 < 50%. FVC was 90% ± 13%, and was less than 80% in 10 subjects (18,5%). Four cases (7,4%) had TLC < 80%. The FEV1/FVC ratio was < 70% in 11 cases (20,4%). Two subjects (3,7%) had low α-1-antitrypsin.
CONCLUSIONS: The percentage of smokers was high despite a history of potentially serious lung disease. The prevalence of airflow obstruction is not entirely attributable to tobacco consumption. Despite excluding pleurisy, a restrictive defect was detected in a relevant percentage of subjects. Notwithstanding correct treatment, pulmonary function alterations were found over a decade after the tuberculosis episode.
CLINICAL IMPLICATIONS: Pulmonary TB affects lung function. The prevalence of obstruction and restrictive deffects are high.
DISCLOSURE: The following authors have nothing to disclose: Pedro Marcos, Isabel Otero, Maria Fernández-Marrube, Maria Rodriguez-Valcarcel, Luis Mariñas, Laura Nuñez-Naveira, David Ramos, Daniel Diaz-Cabanela, Hector Verea
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