Relation between pulmonary tuberculosis and chronic obstructive pulmonary disease

Background/aim
Some studies have showed a link between pulmonary tuberculosis (TB) and the growth of chronic obstructive pulmonary disease (COPD). So, the aim of this work was to study the prevalence of TB-associated COPD among patients with COPD.


Patients and methods
This study included 500 patients with a precise COPD diagnosis. It has been established in patients with preceding history of pulmonary or extrapulmonary TB. The patients were separated into two equivalent groups: group 1 contained 50 patients with TB-associated COPD, and group 2 contained 50 patients with COPD but without TB history. All included patients underwent full history, complete clinical examination, chest radiography, arterial blood gases, and pulmonary function tests.


Results
The prevalence of TB-associated COPD among the 500 patients with COPD was 16%. There was a significant difference in smoking habit between both groups (P=0.001). The mainstream of TB-associated COPD group was nonsmokers, even though most patients with COPD without TB were smokers. There was a significant increase in exacerbations in TB-associated COPD group when equated with patients with COPD without TB (P=0.02). Additionally, there was a significant increase in PaCO2 of the TB-associated COPD group compared with the other group (P=0.02). Moreover, this study recorded significant relation between the beginning of COPD and the number of anti-TB courses (P=0.001), and increased number of anti-TB courses was associated with earlier onset of COPD. The authors observed significant reduction in PFTs in patients who received two or more courses compared with patients who had customary only one course.


Conclusions
TB should be considered in patients with COPD, and COPD can be a consequence of TB even in the absence of any other risk factors. COPD-associated TB is associated with frequent exacerbations, worsened pulmonary function tests, and earlier start of COPD compared with patients with COPD owing to other risk factors.