Introduction: Anthtacofibrosis is commonly seen in non-smoker elderly female with biomass fuel smoke exposure. The disease is commonly reported from rural area, where biomass fuel is use as primary source of heating/cooking. Ladakh is a high altitude plateau with commonly using biomass fuel due to it geography and climatic condition. The study was done with aim to study the profile anthracofibrosis among patients of Ladakh. Method: This is a retrospective observational study conducted at a tertiary chest centre of India. We enrolled all cases of bronchoscopical confirmed anthracosis/ anthracofibrosis of Ladakh. We review the patient’s file and analysis for demographic profile, symptoms, clinical findings, X-ray chest, CECT, bronchoscopy, lung function parameters, cytology of BAL and bronchial biopsy. Result: The study enrolled 26 confirm cases of anthracosis from Ladakh. The mean age was 63±8.8 years with majority 17(65%) were female. The history of biomass fuel smoking exposure was found in all case with 15(58%) house maker by occupation. The most common symptoms were cough and breathlessness 85%. The history of hemoptysis was seen five and hoarseness in two cases. The spirometry was abnormal in 12(60%) patients with obstructive abnormality being the common type. The most common type of lung lesion on X-ray was nodules 22(85%) and reticular 16(62%) cases. On CT chest the most common lung abnormality was nodules seen in 24(92%) and calcified enlarged mediatinal lymph nodes 18(69%) cases. On bronchoscopy the multiple anthracotic pigmentations was found all and bilateral in 24(92%) cases with anatomical distortion of bronchial tree was seen in 16(62%) cases. The anthracotic pigment on histopathology specimen was found in 21(81%) cases. Conclusion: Anthracosis is seen to be a common environmental lung disease in Ladakh due to its geography and living style. The change in heating system should encourage to prevention. Bronchoscopy facility should available for confirm diagnosis.
Spalgais et al. (Tue,) studied this question.