PURPOSE: Everything that wheezes is not asthma. Asthma and other causes of wheezing need to be treated differentially. Screening the patients of quiescent/active Tuberculosis presenting with breathlessness and rhonchi on auscultation is required to rule out the cause, whether bronchial asthma or some other etiology. Aim was to find association between the two diseases and give treatment according to the etiology.
METHODS: Patients of Tuberculosis presenting to the Department of Tuberculosis and Chest Diseases, Government Medical College, Patiala, Punjab, India with complaints of breathlessness and having rhonchi on examination were subjected to bronchodilator reversibility testing to prove whether suffering from concomitant asthma. Patients thus having both Tuberculosis and asthma were analyzed in terms of family history of asthma, whether asthma developed before or after Tuberculosis and the correlation of radiological extent of the disease and lung function abnormalities.
RESULTS: 69 patients of Tuberculosis and asthma were found. 48/69 (69.6%) patients developed asthma after Tuberculosis while 21/69 (30.4%) patients developed Tuberculosis after asthma. Amongst 48 patients who developed Asthma after Tuberculosis, only 2 (2.9%) patients had a positive family history for Asthma and 25 (52.1%) patients developed asthma within 5 years and 11 (22.9%) between 6-10 years of completion of ATT. Lung function abnormalities correlated with the radiological extent.
CONCLUSION: Breathlessness and rhonchi can be because of several causes in patients of Tuberculosis. These patients should be subjected to bronchodilator reversibility testing and if positive, should be treated as per asthma guidelines.
CLINICAL IMPLICATIONS: In a treated case of Tuberculosis presenting with breathlessness and rhonchi, the diagnosis of asthma by reversibility test should be established to avoid unnecessary use of high dose of inhaled/ oral steroids in non asthamtics presenting with these features.
DISCLOSURE: Kranti Garg, No Financial Disclosure Information; No Product/Research Disclosure Information