Co Morbidities in Chronic Obstructive Pulmonary Disease, Are We Aware

Introduction: COPD is a major cause of morbidity andmortality worldwide Besides lungs it has systemic effects,co morbidities. These co morbidities increase the risk ofexacerbation, reduce health status and increase risk ofmortality. The primary objective of this study was to assesthe various co morbidities in COPD patients, to study thedifference in proportion of co morbidities in smokers ascompared to the non-smokers and to study the proportion ofvarious co morbidities according to GOLD stageMaterial and methods: We studied 55 consecutive COPDpatients who presented to the department of pulmonarymedicine, Goa Medical College from August 2016 to July2017.Results: Out of the 55 patients included in the study 34(61.8%) were males and 21(31.8%) were females, age (meanand SD) 67.32±9.46, FEV1% (mean and SD) 47.45±12.78,FEV1/FVC% (mean and SD) 57.05±9.11, 36(65.4%) weresmokers with pack /year (mean and SD) 26.08±17.55, and19(34.5%) had biomass exposure with Biomass exposureindex (mean and SD)104.54±71.05 and Hb (mean and SD)was 12.83±2.19. The most frequent co morbidties werehypertension 54.5% (30 cases), followed by psychologicaldisturbance like depression 43.6% (24 cases). Percentage ofco morbidities were higher in the COPD patients exposed totobacco smoke as compared to biomass smoke. Percentage ofco morbidities were higher in the very severe stage of COPDas compared to the other stages of COPD.Conclusion: We recommend as a general practice to assesco morbidities in all COPD patients and vise versa as the comorbidities play a important role in exacerbation, reducinghealth status and increasing risk of mortality

Immunoglobulin G Subclass Deficiencies in Adult Patients with Chronic Airway Diseases

Immunoglobulin G subclass deficiency (IgGSCD) is a relatively common primary immunodeficiency disease (PI) in adults. The biological significance of IgGSCD in patients with chronic airway diseases is controversial. We conducted a retrospective study to characterize the clinical features of IgGSCD in this population. This study examined the medical charts from 59 adult patients with IgGSCD who had bronchial asthma or chronic obstructive pulmonary disease (COPD) from January 2007 to December 2012. Subjects were classified according to the 10 warning signs developed by the Jeffrey Modell Foundation (JMF) and divided into two patient groups: group I (n = 17) met ≥ two JMF criteria, whereas group II (n = 42) met none. IgG3 deficiency was the most common subclass deficiency (88.1%), followed by IgG4 (15.3%). The most common infectious complication was pneumonia, followed by recurrent bronchitis, and rhinosinusitis. The numbers of infections, hospitalizations, and exacerbations of asthma or COPD per year were significantly higher in group I than in group II (P < 0.001, P = 0.012, and P < 0.001, respectively). The follow-up mean forced expiratory volume (FEV1) level in group I was significantly lower than it was at baseline despite treatment of asthma or COPD (P = 0.036). In conclusion, IgGSCD is an important PI in the subset of patients with chronic airway diseases who had recurrent upper and lower respiratory infections as they presented with exacerbation-prone phenotypes, decline in lung function, and subsequently poor prognosis.