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Airflow obstruction and chronic obstructive pulmonary disease are common in pulmonary tuberculosis even without sequelae findings on chest X-ray

 Hye Jung Park  ;  Min Kwang Byun  ;  Jaeuk Lee  ;  Chi Young Kim  ;  Sojung Shin  ;  Youlim Kim  ;  Chin Kook Rhee  ;  Ki Suck Jung  ;  Kwang Ha Yoo 
 INFECTIOUS DISEASES, Vol.55(8) : 533-542, 2023-08 
Journal Title
Issue Date
Humans ; Lung ; Nutrition Surveys ; Pulmonary Disease, Chronic Obstructive* / complications ; Pulmonary Disease, Chronic Obstructive* / diagnostic imaging ; Pulmonary Disease, Chronic Obstructive* / epidemiology ; Tuberculosis, Pulmonary* / complications ; Tuberculosis, Pulmonary* / diagnostic imaging ; Tuberculosis, Pulmonary* / epidemiology ; X-Rays
COPD ; Pulmonary tuberculosis ; airflow obstruction
Purpose: Pulmonary tuberculosis (TB) is a well-known risk factor for airflow obstruction and chronic obstructive pulmonary disease (COPD). The prognosis of TB without sequelae on chest X-ray (CXR) remains uncertain.

Methods: We used the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES) data and 2007-2012 KNHANES-matched Health Insurance Review and Assessment Service cohort data. Airflow obstruction was assessed using a pulmonary function test. COPD was defined using diagnostic codes and the use of COPD medication for 3-year. We classified subjects into three groups based on TB history and sequelae on CXR.

Results: In 4911 subjects, the CXR(-) (no TB sequelae on CXR) post-TB group (n = 134) showed similar characteristics and normal lung function compared to that of the control group (n = 4,405), while the CXR(+) (TB sequelae on CXR) post-TB group (n = 372) showed different characteristics and reduced lung function. The prevalence of airflow obstruction was 9.3%, 13.4%, and 26.6% in control, CXR(-) post-TB, and CXR(+) post-TB groups, respectively. COPD was more common in the post-TB with CXR(+) (6.5%) or without CXR (-) (4.5%) groups, than in the control group (1.8%). Compared to the CXR(-) post-TB group, the control group showed a lower risk for airflow obstruction (OR, 0.774; p = .008). The CXR(+) post-TB group showed a higher risk for airflow obstruction (OR, 1.456; p = .011). The Control group also showed a lower risk for the development of COPD than the CXR(-) post-TB group (OR, 0.496; p = .011).

Conclusions: We need to educate TB patients that airway obstruction and COPD can easily develop, even if TB sequelae are not observed on CXR.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chi Young(김치영)
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Lee, Jaeuk(이재욱)
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