Presarcopenia and chronic cough due to chronic obstructive pulmonary disease successfully treated with nutraceutical supplements and physical exercise

Abstract

Objective: To describe a patient with presarcopenia and chronic cough secondary to chronic obstructive pulmonary disease (COPD) successfully treated with supplements and physical exercise.Case report: A 75-year-old female patient with a positive past medical history of systemic hypertension, dyslipidemia, heart arrhythmia, and smoking during 20 years evolved with chronic cough due to a chronic obstructive pulmonary disease diagnosed ten years ago. She came to our private clinic due to low weight, low energy. Her weight was 44.8 kg, her height 1.57 m, body mass index of 18.18 kg/m2. Laboratory tests showed SDHEA 76.3, vitamin D of 15.6 ng/ml (nr: > 30 ng/ml), C-reactive protein (CRP) of 55 mg/ml. Computed tomography showed bronchiectasis. She had an skeletal muscle mass index of 5.0 kg/m2 (nr: > 5.5 kg/m2) by DXA. A diagnosis of presarcopenia was determined based on DXA evaluation with low muscle mass but normal gait speed handgrip strength. We suggested to the patient to increase physical exercise and prescribed a supplement formula. After five months, she returned asymptomatic, without cough, marked improvement of fatigue, increased energy levels, and weight increased to 50 kg, BMI of 20.28 kg/m2. Laboratory tests showed SDHEA to 140, vitamin D3 to 64.5 ng/ml, reduced CRP reduced to 5 mg/dl, and amlodipine was excluded due to better blood pressure control. Currently, two years later, the patient continues without cough and has dyspnea only with high efforts, without fatigue, and her weight is 52 kg and BMI 21.1 kg/m2. She also reduced her conventional treatment for COPD, using only a bronchodilator on-demand, without topical corticoids.Conclusions: This case illustrates an interesting case of a patient with presarcopenia and chronic cough, refractory to conventional approach, successfully treated with a combination of nutraceuticals and physical exercises.