A Study of the Bronchial Provocation Test with Methacholine in Patients with Active Pulmonary Tuberculosis

Bronchial hyperreactivity is a characteristic feature of bronchial asthma. Recent respiratory infections, allergic rhinitis, atopic family history, pulmonary tuberculosis, pulmonary sarcoidosis, cystic fibrosis, and farmer's lung have also been demonstrated to have bronchial hyperreactivity to inhaled methacholine. It is not known if pulmonary tuberculosis can cause nonspecific bronchial hyperreactivity and what the mechanism would be. We therefore undertook to evaluate nonspecific bronchial hyperreactivity in active pulmonary tuberculosis using the bronchial provocation test with methacholine and we measured the total serum IgE and peripheral eosinophil count to seek some mechanisms. There were 5 patients among 18 subjects with active pulmonary tuberculosis whose response to methacholine was positive. The mean baseline FEV1 of positive responders was 71.40 +/- 17.39%, and that of negative responders was 110.18 +/- 17.65% (p less than 0.05). There were no significant differences in serum IgE and peripheral eosinophil count between positive and negative responders. We found that active pulmonary tuberculosis would increase the nonspecific bronchial response with methacholine, and the mechanism of the bronchial hyperreactivity in patients with active pulmonary tuberculosis may not be related to an immunologic mechanism but may be related to the stimulating receptors.