Chronic obstructive pulmonary disease (COPD)
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Chronic obstructive pulmonary disease (COPD)
Fasting laboratory tests
- Fasting plasma glucose
- Lipid profile
- FBC
- NT-proBNP (if heart failure or pulmonary hypertension suspected)if neededSuspected heart failure or pulmonary hypertension: the HAS guide then provides for ECG, natriuretic peptide and echocardiography [2].
Microbiology tests
- Sputum culture (if purulent sputum persists despite antibiotic treatment)if neededThe HAS guide (2019) provides for it in case of persistent purulent expectoration after antibiotic failure or in a particular patient context [2]. NICE requests it if expectoration is persistent and purulent [3]. The Australian COPD-X (2025) judges it useless routinely in stable patients and recommends it if an infection does not respond to antibiotics or if a resistant organism is suspected [4].
Do not order
- Serum albumin, transthyretin (prealbumin) to screen for undernutrition: not recommended, not sensitive enough and influenced by the inflammatory state [2]
Testing for alpha-1 antitrypsin deficiency
Laboratory tests (once)
- Alpha-1 antitrypsin (serum level)
- CRP (at the same time as the level)if needednon-French guidelineTo interpret an alpha-1 antitrypsin level that could be raised by an inflammatory reaction: the ERS algorithm pairs a CRP with the assay [8].
- If the level is low: phenotyping or genotyping in a specialised laboratory (genetic test: written consent), together with the respiratory physician.
Also consider
- Unexplained raised transaminases? Alpha-1 antitrypsin deficiency exposes to liver disease: if unexplained raised transaminases, see the page Élévation des transaminases.
Sources (10)
- Haute Autorité de santé. BPCO – Causes fréquentes : tabagisme et expositions professionnelles (page web), consultée le 24/10/2026.
- Guide du parcours de soins Bronchopneumopathie chronique obstructive
- National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline NG115, 5 décembre 2018, mise à jour du 26 juillet 2019.
- Yang IA, George J, McDonald CF, Disler R, Ordman R, Goodwin A, Smith B, McNamara R, Zwar N, Dabscheck E. The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2025. Version 2.78, octobre 2025, section C5.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2026 report, version 1.3, 8 décembre 2025.
- US Department of Veterans Affairs, US Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Chronic Obstructive Pulmonary Disease. Version 4.0, septembre 2026.
- Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie COPD, 2. Auflage, Version 1, 2021. Kapitel 2 : Diagnostik und Monitoring.
- Miravitlles M, Dirksen A, Ferrarotti I, Koblizek V, Lange P, Mahadeva R, et al. European Respiratory Society statement: diagnosis and treatment of pulmonary disease in α1-antitrypsin deficiency. Eur Respir J 2017;50(5):1700610.
- Cagle SD Jr, Landrum LS, Kennedy AM. Chronic Obstructive Pulmonary Disease: Diagnosis and Management. Am Fam Physician. 2023;107(6):604-612.
- BPCO – Causes fréquentes : tabagisme et expositions professionnelles