Abstract
Introduction: Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR). Objective: Evaluate the ESR and the CRP as markers for diagnosis and monitoring cases of pulmonary tuberculosis. Method: Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three different times: at diagnosis, before starting treatment (T0), after three months of treatment (T1), and at the end of treatment (T2). Results: 51 patients were studied at T0 (100%), 43 (84.31%) at T1, and 32 (62.74%) at T2. ESR and CRP values presented significant differences in the three different times (p < 0.0001***). When analyzing the relationship between negative/positive sputum and altered/normal ESR and CRP at T0, ESR (p = 0.0691), CRP (p = 0.0166*). For chest imaging and sputum smear variables it was observed the following: CRP versus smear (p = 0.0002***), ESR versus smear (p = 0.3810), CRP versus chest imaging (p = 0.0097**), and ESR versus chest imaging (p = 0.0766). The correlation between ESR and CRP was: T0 (p = 0.0033**), T1 (p < 0.0001***) and T2 (p = 0.0015**). Conclusion: ESR and CRP proved to be good markers in the diagnosis and monitoring of tuberculosis cases, however, CRP achieve more significant results than ESR.
Highlights
Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR)
Data analyzes and blood collections were carried out in the period from September 13, 2012 to December 17, 2013; the inclusion criterion was the diagnosis of pulmonary tuberculosis performed by clinical laboratory data, in sputum smear microscopy and/or sputum culture, carried out by Ziehl-Neelsen and Löwenstein_Jensen (LJ) methods, respectively, associated with chest image (CI), X-ray test and/or CT scan, besides not having yet started anti-TB treatment for the first blood collection of the study
This study, among patients with pulmonary tuberculosis were identified several associated comorbidities, such as smoking, alcohol consumption, drug abuse, diabetes mellitus (DM), human immunodeficiency virus (HIV) seropositivity and anemia (Table 1). These comorbidities are strongly related to tuberculosis, as shown by several studies: smoking is present in more than half of the patients [11, 19], DM showed an index of 13.2%(12), and HIV, 4.6%(18)
Summary
Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR). Method: Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three different times: at diagnosis, before starting treatment (T0), after three months of treatment (T1), and at the end of treatment (T2). Conclusion: ESR and CRP proved to be good markers in the diagnosis and monitoring of tuberculosis cases, CRP achieve more significant results than ESR. Among the APR proteins, the C-reactive protein (CRP) stands out, since its serum level is increased about a thousand times during acute inflammation This protein binds to a variety of pathogens and activates the proteins from complement system, First submission on 11/08/14; last submission on 27/11/14; accepted for publication on 29/11/14; published on 20/12/14 1. Phd in Clinical and Toxicological Analysos by Minas Gerais Federal University (UFMG); teaching the discipline of Hematology of Pharmacy and Biomedical Sciences at Univali
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