Successful Treatment of Endobronchial Tuberculosis in Persahabatan National Respiratory Referral Hospital

Adistya Sari, Wahju Aniwidyaningsih, Erlina Burhan

Abstract


Backgrounds: Endobronchial tuberculosis (EBTB) is a special form of respiratory tuberculosis that continues to be a health problem because bronchostenosis may develop as a serious complication despite efficacious antituberculosis chemotherapy. The EBTB has nonspesific signs and symptoms, therefor it may cause misdiagnosis and delayed diagnosis. Persahabatan National Respiratory Referral Hospital doesn’t have data about successful treatment of EBTB
Methods: This was a retrospective study of EBTB patients based from the medical record and confirm with bronchoscopy data from January 2013 to December 2017. Endobronchial tuberculosis diagnosed based from microbiology, histopathology examination or based on combination of clinical symptoms, radiology and bronchoscopy lesion appearance. Endobronchial tuberculosis treatment considered successful if there is improvement in clinical symptoms, microbiological conversion, accompanied by improvement or no change in the number of lesions or the radiological appearance.
Results: The study sample consisted of 30 subjects. Majority of the subjects were female (86,7%), age <20-39 years (73,3%), highly educated (90%), not working (56,6%), malnutrition (58,3%), never received antituberculosis medication (63,3%), not smoking (86,7%) and has no comorbidities (76,6%). Shortness of breath (83.3%) is the most complained symptom. Stridor and rhonchi are the most frequent signs (36.7%). Infiltrate, fibroinfiltrates and consolidation are the most common radiological images on chest X-ray (26.6%). Whereas most chest CT scans obtained a consolidated picture (45%). Most EBTB lesions were fibrostenosis (86,7%) found in the trachea (60%). Seventy percent of patients received non-fix dose combination (FDC) type antituberculosis treatment (ATT), received inhaled steroids (73.3%) with a median duration of TBEB treatment was 12 months. Complaints improved after administration of ATT in clinical symptoms in 76% of patients, bronchoscopy 20% patients, chest X-ray 23% patients and CT scans 16.6% patients.
Conclusions: The success of EBTB treatment is 43%, as many as 17% of complaints improve with sequels and 40% cannot be assessed.

Keywords


endobronchial, tuberculosis, bronchoscopy, fibrostenosis

References


Ratnawati. 2011. Epidemiologi Asma. Jurnal Respirologi Indonesia [Editorial]. Vol 31(4), pp. 172- 175.

Atmoko W., Khairina H. P. F., Bobian E. T., Adisworo M. W., Yunus F. 2011. Prevalensi Asma Tidak Terkontrol dan Faktor-Faktor yang Berhubungan dengan Tingkat Kontrol Asma di Poliklinik Asma Rumah Sakit Persahabatan, Jakarta. J Respir Indo, Vol. 31, No. 2, hal. 53- 60.

Angulo M., Lecuona E., Sznajder J. I. 2012. Role of MicroRNAs in lung disease. Archivos de Bronconeumología (English Edition), vol.48, pp. 325-330.

Greene C.M., Gaughan K.P. 2013. microRNAs in asthma: potential therapeutic targets. Curr Opin Pulm Med, vol.19, pp.66– 72.

Corren J. 2013. Role of Interleukin-13 in Asthma. Curr Allergy Asthma Rep, vol. 13, pp. 415- 420.

Garbacki N., Di Valentin E., Huynh-Thu V. A., Geurts P., Irrthum A., Crahay C. et al. 2011. MicroRNAs profiling in murine models of acute and chronic asthma: a relationship with mRNAs targets. PLoS One, vol. 6; 1;e16509, pp. 1- 23.

Kabesch M., Addock I. M. 2012. Epigenetics in asthma and COPD. Biochimie, vol. 94, pp. 2231- 41.

Collison A., Herbert C., Siegle, J. S., Mattes J., Foster P. S., Kumar R. K. 2011b. Altered expression of microRNA in the airway wall in chronic asthma: miR-126 as a potential therapeutic target. BMC pulmonary medicine, vol. 11, pp. 29- 34.

Suojalehto H., Lindström I., Majuri M., Mitts C., Karjalainen J., Wolff H., et al. 2014. Altered MicroRNA Expression of Nasal Mucosa in Long-Term Asthma and Allergic Rhinitis. Int Arch Allergy Immunol 2014, vol. 163, pp. 168–178

Morris M. J. 2017. Asthma. (Online), https://emedicine.medscape.com/ article/296301-overview, Updated: Nov 20, 2017, diakses 20 Maret 2018)

Wang S. S. 2017. Metabolic Syndrome. (Online), https://emedicine.medscape.com/article/165124-overview, Updated: March 29, 2017, diakses 05 Mei 2019)

17. Amin M., Djajalaksana S., Wiyono W. H., Yunus F., Suradi, Sutoyo D., K., et al. 2018. Asma; Pedoman Diagnosis dan Penatalaksanaan di Indonesia, Edisi Revisi 1, Perhimpunan Dokter Paru Indonesia, Jakarta, hal. 30- 36.

GINA, 2017. Global Strategy for Asthma Management and Prevention. Vancouver: GINA Board.

Rahayu, 2013. Hubungan Tingkat Kontrol Asma Dan Kualitas Hidup Penderita Asma Yang Berobat Di Rsud Dokter Soedarso Pontianak Pada Bulan Maret Sampai Dengan Mei Tahun 2012. Jurnal Untan 2013, vol.3 no.1, hal. 1-17.

Yuliati D., Djajalaksana S., Al Rasyid H. 2014. Increasing Level Of Interleukin- 10, Interleukin- 17 And ACT Scoring in Asthma Bronchial Patient With Vitamin D Deficiency After 2 Months Supplementation Of 800 IU Vitamin D. Indonesian Journal of Respirology, vol. 19, pp.6

Comberiati P., Cicco M., E., D’Elios S., Peroni D., G. 2017. How Much Asthma Is Atopic in Children? Front Pediatr; vol. 5, p. 122.

Price D. B., Rigazio A., Campbell J. D., Corrigan C. J., Thomas M., Wenzel S. E, et al. 2015. Blood eosinophil count and prospective annual asthma

disease burden: a UK cohort study. Lancet Respir Med, vol.3 (11), pp. 849-58.

Kai W., Qian X. U., Qun W. Z. 2015. MicroRNAs and Asthma Regulation. Iran J Allergy Asthma Immunol, vol.14 (2), pp. 120- 125.

Fallahi M., Keyhanmanesh R., Khamaneh A.M., Saadatlou M. A. E., Saadat S., Ebrahimi H. 2016. Effect of Alpha-Hederin, the active constituent of Nigella sativa, on miRNA-126, IL-13 mRNA levels and inflammation of lungs in ovalbumin-sensitized male rats. Avicenna Journal of Phytomedicine, vol. 6, no.1, pp. 77- 85.

Surjanto E., Purnomo J. 2018. Mekanisme Seluler dalam Patogenesis Asma dan Rinitis (Online), (http://jurnalrespirologi.org/jurnal/Juli09/MEKANISME%20SELULER%20DALAM%20PATOGENESIS%20ASMA%20DAN%20RINITIS_OK.pdf, diakses 20 Maret 2018).

Oh C. K., Geba G. P., Molfino N. 2010. Investigational Therapeutics Targeting the IL-4/ IL-13/ STAT-6 Pathway for the Treatment of Asthma. Eur Respir Rev, vol 19 (115), pp. 46- 54.

Brightling C. E., Chanez P., Leigh R., O’Byrne P. M., Korn S., She D., et al. 2015. Efficacy and safety of tralokinumab in patients with severe uncontrolled asthma: a randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Respir Med 2015, vol. 3, pp. 692–701.




DOI: https://doi.org/10.36497/jri.v40i2.102

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