Obstructive pulmonary disease in patients with previous tuberculosis : pathophysiology of a community-based cohort

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dc.contributor.authorAllwood, Brian W.en_ZA
dc.contributor.authorGillespie, Renciaen_ZA
dc.contributor.authorGalperin-Aizenberg, Mayaen_ZA
dc.contributor.authorBateman, Maryen_ZA
dc.contributor.authorOlckers, Helenaen_ZA
dc.contributor.authorTaborda-Barata, Luisen_ZA
dc.contributor.authorCalligaro, Gregory L.en_ZA
dc.contributor.authorSaid-Hartley, Qonitaen_ZA
dc.contributor.authorVan Zyl-Smit, Richarden_ZA
dc.contributor.authorCooper, Christopher B.en_ZA
dc.contributor.authorVan Rikxoort, Evaen_ZA
dc.contributor.authorGoldin, Jonathanen_ZA
dc.contributor.authorBeyers, Nuldaen_ZA
dc.contributor.authorBateman, Eric D.en_ZA
dc.date.accessioned2018-11-27T09:22:31Z
dc.date.available2018-11-27T09:22:31Z
dc.date.issued2017
dc.descriptionCITATION: Allwood, B. W., et al. 2017. Obstructive pulmonary disease in patients with previous tuberculosis : pathophysiology of a community-based cohort. South African Medical Journal, 107(5):440-445, doi:10.7196/SAMJ.2017.v107i5.12118.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. An association between chronic airflow limitation (CAL) and a history of pulmonary tuberculosis (PTB) has been confirmed in epidemiological studies, but the mechanisms responsible for this association are unclear. It is debated whether CAL in this context should be viewed as chronic obstructive pulmonary disease (COPD) or a separate phenotype. Objective. To compare lung physiology and high-resolution computed tomography (HRCT) findings in subjects with CAL and evidence of previous (healed) PTB with those in subjects with smoking-related COPD without evidence of previous PTB. Methods. Subjects with CAL identified during a Burden of Obstructive Lung Disease (BOLD) study performed in South Africa were studied. Investigations included questionnaires, lung physiology (spirometry, body plethysmography and diffusing capacity) and quantitative HRCT scans to assess bronchial anatomy and the presence of emphysema (<–950 HU), gas trapping (<–860 HU) and fibrosis (>–200 HU). Findings in subjects with a past history and/or HRCT evidence of PTB were compared with those in subjects without these features. Results. One hundred and seven of 196 eligible subjects (54.6%) were enrolled, 104 performed physiology tests and 94 had an HRCT scan. Based on history and HRCT findings, subjects were categorised as no previous PTB (NPTB, n=31), probable previous PTB (n=33) or definite previous PTB (DPTB, n=39). Subjects with DPTB had a lower diffusing capacity (Δ=–17.7%; p=0.001) and inspiratory capacity (Δ=–21.5%; p=0.001) than NPTB subjects, and higher gas-trapping and fibrosis but not emphysema scores (Δ=+6.2% (p=0.021), +0.36% (p=0.017) and +3.5% (p=0.098), respectively). Conclusions. The mechanisms of CAL associated with previous PTB appear to differ from those in the more common smoking-related COPD and warrant further study.en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/11885
dc.description.versionPublisher's version
dc.format.extent6 pages
dc.identifier.citationAllwood, B. W., et al. 2017. Obstructive pulmonary disease in patients with previous tuberculosis : pathophysiology of a community-based cohort. South African Medical Journal, 107(5):440-445, doi:10.7196/SAMJ.2017.v107i5.12118
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2017.v107i5.12118
dc.identifier.urihttp://hdl.handle.net/10019.1/104734
dc.language.isoen_ZAen_ZA
dc.publisherHealth & Medical Publishing Group
dc.rights.holderHealth & Medical Publishing Group
dc.subjectChronic obstructive pulmonary diseaseen_ZA
dc.subjectLungs -- Diseasesen_ZA
dc.subjectTuberculosis patients -- Susceptibility to pulmonary diseasesen_ZA
dc.subjectTuberculosis -- Pathophysiologyen_ZA
dc.subjectChronic airflow limitationen_ZA
dc.titleObstructive pulmonary disease in patients with previous tuberculosis : pathophysiology of a community-based cohorten_ZA
dc.typeArticleen_ZA
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