ACUTE PHASE INFLAMMATORY RESPONSE IN PATIENTS WITH PULMONARY TUBERCULOSIS

Abstract

Introduction: Tuberculosis (TB) is a common infectious disease caused by Mycobacterium tuberculosis (MTB). Although no other current test is more reliable for determining the activity of PTB than culture growth of bacilli, some biochemical parameters that reflect the inflammation present in patients with this condition may provide guidance at the diagnostic stage. The mean platelet volume (MPV) reflects the size of platelets. It has been shown to be inversely correlated with level of the inflammation in some chronic inflammatory diseases. Aim of the Work: This study aims to evaluate the role of some inflammatory markers in patients with active pulmonary tuberculosis (PTB) and to investigate the relationship between the inflammatory markers with each other as well as with the sputum smear positivity for TB bacilli. Methods: This cross sectional study included 50 patients who presented to the outpatient clinic of Qena general chest hospital and were diagnosed with active pulmonary tuberculosis and 50 healthy subjects(control group) who presented to the outpatient clinic for routine examination and presented no disease during the period between April 2017 to October 2017. Complete blood count, C-reactive protein (CRP) level, Erythrocyte sedimentation rate(ESR), ferritin level, and albumin level were compared between the two groups. In the PTB group, the relationship between inflammatory markers with each other as well as with sputum smear positivity for TB bacilli were investigated. Results: The MPV was 7.46±0.71 fl in the PTB group and 8.02±0.56 fl in the control group(p=.000). The blood platelets count, CRP levels, ESR and ferritin levels were significantly higher in the active PTB group than in the control group(p=.000). In the PTB group, CRP levels(p=.012) and platelets count(p=.026) but not ESR(p=.565) and MPV(p=.392) were significantly correlated with the sputum smear positivity for TB bacilli. Conclusions: The MPV was lower in patients with PTB than in healthy controls but the difference was limited. The MPV does not reflect the severity of the disease. The use of MPV as an inflammatory marker and a negative acute phase reactant in PTB does not seem to be reliable. The ESR and CRP proved to be good markers for the severity of pulmonary tuberculosis. However CRP showed more significant results than ESR in determining the disease severity.