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Role of DLCO in Differentiation or Subtyping of Obstructive Lung Disease Beyond Spirometry and CT Scan


Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
2 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
3 Senior Resident, Department of Respiratory Medicine, MMMC & H, Kumarhatti, Solan, Himachal Pradesh, India
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
     

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Introduction: Spirometry helps us to differentiate between obstructive and restrictive disease, body plethysmography tells about lung volumes and DLCO about diffusion defect. Determining which tests to do depends on the clinical question to be answered i.e. whether test is being done to diagnose a disease or for evaluation for lung surgery or some other reason. Material and Method: 46 patients coming to department of respiratory medicine, who were diagnosed with obstructive lung disease by PFT as per GOLD guidelines were considered for the study. Chest X-ray and CT chest were also done. Then DLCO was performed in every patient. Single breath hold method was used in the study. The report of the DLCO was interpreted according to the American Thoracic Society/European Respiratory Society statement on PFT interpretation. Results: Male preponderance was seen in study cases with 65.2% males to 34.8% females. Mean age of the study group was 54.39 years with most cases (18) from 31-50 years of age group. Most common diagnosis was COPD emphysema (22) followed by chronic bronchitis (12), bronchial asthma (10) and bronchiectasis (2). Among obstructive lung diseases, B. asthma had the highest mean DLCO percentage predicted of 102.20 ± 14.36 followed by COPD-Bronchitis (76.33±5.57), COPD–Emphysema (37.80±13.41) and bronchiectasis (62±4.48). Conclusion: DLCO can be helpful beyond spirometry in classification of obstructive lung diseases. DLCO values in COPD Emphysema variant are decreased, COPD bronchitis variant remains normal or slightly reduced and asthma either normal or increased. So, DLCO can help in differentiation or sub categorization of obstructive disease more than spirometry.

Keywords

DLCO, Obstructive diseases, Lung function test, COPD, Emphysema, Bronchial Asthma.
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  • Role of DLCO in Differentiation or Subtyping of Obstructive Lung Disease Beyond Spirometry and CT Scan

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Authors

Vishvdeep Saini
Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
Sameer Singhal
Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
Sukhjinder Pal Singh
Senior Resident, Department of Respiratory Medicine, MMMC & H, Kumarhatti, Solan, Himachal Pradesh, India
Achchhar Singh
Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India
Aditi Gupta
Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, India

Abstract


Introduction: Spirometry helps us to differentiate between obstructive and restrictive disease, body plethysmography tells about lung volumes and DLCO about diffusion defect. Determining which tests to do depends on the clinical question to be answered i.e. whether test is being done to diagnose a disease or for evaluation for lung surgery or some other reason. Material and Method: 46 patients coming to department of respiratory medicine, who were diagnosed with obstructive lung disease by PFT as per GOLD guidelines were considered for the study. Chest X-ray and CT chest were also done. Then DLCO was performed in every patient. Single breath hold method was used in the study. The report of the DLCO was interpreted according to the American Thoracic Society/European Respiratory Society statement on PFT interpretation. Results: Male preponderance was seen in study cases with 65.2% males to 34.8% females. Mean age of the study group was 54.39 years with most cases (18) from 31-50 years of age group. Most common diagnosis was COPD emphysema (22) followed by chronic bronchitis (12), bronchial asthma (10) and bronchiectasis (2). Among obstructive lung diseases, B. asthma had the highest mean DLCO percentage predicted of 102.20 ± 14.36 followed by COPD-Bronchitis (76.33±5.57), COPD–Emphysema (37.80±13.41) and bronchiectasis (62±4.48). Conclusion: DLCO can be helpful beyond spirometry in classification of obstructive lung diseases. DLCO values in COPD Emphysema variant are decreased, COPD bronchitis variant remains normal or slightly reduced and asthma either normal or increased. So, DLCO can help in differentiation or sub categorization of obstructive disease more than spirometry.

Keywords


DLCO, Obstructive diseases, Lung function test, COPD, Emphysema, Bronchial Asthma.



DOI: https://doi.org/10.37506/v11%2Fi2%2F2020%2Fijphrd%2F194921