COPD patients were chosen according to the "Global Initiative for Chronic Obstructive Lung Disease" (GOLD) that defines chronic obstructive pulmonary disease "COPD" as a preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases. All patients were subjected to full history taking, careful general and local examination, routine laboratory investigations, chest x ray, arterial blood gas (ABG) and bronchalveolar lavage cytology.