FREQUENCY OF BLOOD EOSINOPHILIA IN NEWLY DIAGNOSED CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS
Main Article Content
Keywords
Eosinophilia, Chronic Obstructive Pulmonary Disease, Spirometry
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a diverse illness and has various phenotypes both clinical and pathological. Globally ‘Chronic Obstructive Lung Disease’ (GOLD) described COPD as “A common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases”.
Objective: The purpose of this study was to record the incidence of blood eosinophilia in individuals with recently diagnosed COPD
Methods: The study was conducted in Hayatabad Medical Complex (HMC), Peshawar for 6 months between 1st july 2023 to 31st December 2023. The study design was observational cross-sectional study. The study involved 250 participants who had just received a COPD diagnosis. The sample technique was purposive sampling. Individuals with COPD who were ‘40 to 80 years’ old were included in the trial; however, individuals who were on ‘TB medication’ or who had ‘asthma’, ‘asthma COPD overlaps (ACO)’, or ‘bronchiectasis’ were not. The study was approved by the Ethical Review Board of Hayatabad Medical Complex (HMC), Approval No:1835 dated: 18th May 2023.
Results: 250 COPD patients were identified and assessed for Eosinophilia in blood in which 195 (78%) men, and 55 (22%) women with mean age of 65.63 ±11.35 years. Most of the COPD patients had no history of smoking 138 (55.2%) followed by Presently smoking 77 (30.8%), and past -Smokers 35 (14%). Approximately 76 (50.8%) of the COPD patients had exposure to Biomass. Freshly confirmed individuals with COPD were divided into four categories based on the GOLD standard: mild (38, 15.2%), moderate (90, 36%), severe (79, 31.6%), and very severe (43, 17.2%). 110 patients (44%) had confirmed eosinophilic COPD, and 140 patients (56%) had diagnosed non-eosinophilic COPD.
Conclusion: It was determined that a high frequency of blood eosinophilia was present among individuals with recently diagnosed COPD, the majority of whom had moderate-to-severe COPD. Thus, when treating COPD patients, eosinophilia should be taken into account.
References
2. Vestbo J, Agusti A, Wouters EF, Bakke P, Calverley PM, Celli B, et al. Should we view chronic obstructive pulmonary disease differently after ECLIPSE? A clinical perspective from the study team. Am J Respir Crit Care Med. 2014;189(9):1022-1030. doi: 10.1164/rccm.201311- 2006PP
3. Global initiative for chronic obstructive lung disease. GOLD 2019 Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease [Internet].2019. Available from: https://goldcopd.org/ wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL14Nov2018-WMS.pdf. Accessed on Sept. 3,2019.
4. World Health Organization. Chronic obstructive pulmonary disease (COPD) [Fact sheet]. Geneva: World Health Organization; 2017. Available from: https://www.who. int/news-room/fact-sheets/detail/chronic-obstructivepulmonary-disease-(copd).
5. Riley CM, Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review. JAMA. 2019;321(8):786-797. doi: 10.1001/ jama.2019.0131.
6. World Health Organization. Chronic obstructive pulmonary disease (COPD) Geneva, Switzerland: WHO; 2015. Available from: http://www.who.int/respiratory/ copd/en/ Accessed on Sept. 3,2019.
7. Leem AY, Park B, Kim YS, Jung JY, Won S. Incidence and risk of chronic obstructive pulmonary disease in a Korean community-based cohort. Int J Chron Obstruct Pulmon Dis. 2018;13:509-517. doi: 10.2147/COPD.S148618.
8. Eltboli O, Brightling CE. Eosinophils as diagnostic tools in chronic lung disease. Expert Rev Respir Med. 2013;7(1):33- 42. doi: 10.1586/ers.12.81
9. Negewo NA, McDonald VM, Baines KJ, Wark PAB, Simpson JL, Jones PW, et al. Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:1495-1504. doi: 10.2147/COPD.S100338
10. Vedel-Krogh S, Nielsen SF, Lange P, Vestbo J, Nordestgaard BG. Blood eosinophils and exacerbations in chronic obstructive pulmonary disease. The Copenhagen general population study. Am J Respir Crit Care Med. 2016;193(9):965-974. doi: 10.1164/rccm.201509-1869OC
11. Kerkhof M, Sonnappa S, Postma DS, Brusselle G, Agusti A, Anzueto A, et al. Blood eosinophil count and exacerbation risk in patients with COPD. Eur Respir J. 2017;50(1):1700761. doi: 10.1183/13993003.00761-2017
12. Oh YM, Lee KS, Hong Y, Hwang SC, Kim JY, Kim DK, et al. Blood eosinophil count as a prognostic biomarker in COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:3589-3596. doi: 10.2147/COPD.S179734
13. Eltboli O, Mistry V, Barker B, Brightling CE. Relationship between blood and bronchial submucosal eosinophilia and reticular basement membrane thickening in chronic obstructive pulmonary disease. Respirol. 2015;20(4):667- 670. doi: 10.1111/resp.12475
14. Hasegawa K, Camargo CA Jr. Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD. Respirol. 2016;21(4):761-764. doi: 10.1111/ resp.12724
15. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347-365. doi: 10.1164/ rccm.201204-0596PP
16. Han MK, Agusti A, Calverley PM, Celli BR, Criner G, Curtis JL, et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am J Respir Crit Care Med. 2010;182(5):598-604. doi: 10.1164/rccm.200912-1843CC
17. Couillard S, Larivee P, Courteau J, Vanasse A. Eosinophils in COPD exacerbations are associated with increased readmissions. Chest. 2017;151(2):366-373. doi: 10.1016/j. chest.2016.10.003
18. Oshagbemi OA, Burden AM, Braeken DCW, Henskens Y, Wouters EFM, Driessen JHM, et al. Stability of blood eosinophils in patients with chronic obstructive pulmonary disease and in control subjects, and the impact of sex, age, smoking, and baseline counts. Am J Respir Crit Care Med. 2017;195(10):1402-1404. doi: 10.1164/rccm.201701-0009LE
19. Belanger M, Couillard S, Courteau J, Larivee P, Poder TG, Carrier N, et al. Eosinophil counts in first COPD hospitalizations: a comparison of health service utilization. Int J Chron Obstruct Pulmon Dis. 2018;13:3045-3054. doi: 10.2147/COPD.S170743
20. Casanova C, Celli BR, de-Torres JP, Martinez-Gonzalez C, Cosio BG, Pinto-Plata V, et al. Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD. Eur Respir J. 2017;50(5):pii:1701162. doi: 10.1183/13993003.01162-2017
21. Bakr RM, Elmahallawy II. Prevalence characteristics of COPD in never smokers. Egypt J Chest Dis Tuberc. 2012;61(3):59-65. doi: 10.1016/j.ejcdt.2012.10.035
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Sumira Abbas
Assistant Professor Hematology, Department of Pathology, Peshawar Medical College, Kuwait Teaching Hospital Peshawar
Dr Momina Haq
Associate Professor, Department of Physiology, Peshawar Medical College, Riphah International University, Islamabad
Dr Farhan Abbas Baloch
Assistant Professor, Department of Pathology, College of Medicine, Qassim University
Dr Aurangzeb Khan
Associate Professor Pathology, Swat Medical College, Saidu Shareef Swat
Dr Mian Mufarih Shah
Assistant Professor, Department of Medicine, Khyber Girls Medical College, MTI-Hayatabad Medical Complex, Peshawar
Dr Munaza Khattak
Associate Professor, Department of Physiology, Peshawar Dental College, Riphah International University, Islamabad