Haemostatic Indices as Markers for Monitoring Pulmonary Tuberculosis Treatment

##article.authors##

  • P. A Akpan

##semicolon##

Tuberculosis##common.commaListSeparator## Haemostasis##common.commaListSeparator## Inflammation##common.commaListSeparator## Anti-tuberculosis therapy##common.commaListSeparator## Infection

##article.abstract##

Summary: Tuberculosis (TB) is an infectious disease inducing a state of chronic inflammation which could affect the haemostatic mechanism as part of host defences against infection. Proper diagnosis and monitoring of tuberculosis patients undergoing therapy is still a challenge especially in a poor resource country such as Nigeria. This study aims to assess some haemostatic indices of tuberculosis patients and their possible use as markers in monitoring response to anti-tuberculosis treatment. One hundred and twenty TB patients aged 15-60 years and 120 apparently healthy (control) subjects age and gender-matched were studied. Demographic/bio data was compiled by interview and from patients’ case notes. Diagnosis of TB was by sputum smear microscopy, radiography and clinical assessment. Platelet count (PLT), platelet factor 4 (PF4), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin clotting time (TCT) and fibrinogen (FIB) were determined using standard techniques. The platelet factor 4, prothrombin time, activated partial thromboplastin time and fibrinogen levels of TB patients were significantly higher while the thrombin clotting time was significantly lower (P<0.05) when compared with healthy subjects. While PF4, TCT and FIB improved significantly (P<0.05) as anti-tuberculosis therapy progressed, PLT, PT and APTT remained the same. It is concluded that abnormal activation of haemostasis occurs in TB condition thus pre-disposing TB patients to bleeding complications. Furthermore, platelet factor 4, thrombin clotting time and fibrinogen improved as therapy progressed and therefore may be used as markers for monitoring response to anti-tuberculosis therapy.

##submission.citations##

Akpan, P. A, Akpotuzor J. O Akwiwu, E. C. (2012). Some Haematological Parameters of Tuberculosis (TB) Infected Africans: The Nigerian Perspective Journal of Natural Sciences Research 2 (1): 50-56.

Awodu, O. A., Ajayi, I. O. & Famodu, A. A. (2007). Haemorheological variables in Nigeria pulmonary tuberculosis patients undergoing therapy. Clinical Hemorheology and Microcirculation, 36(4), 267-275.

Brooks, G. F., Jawetz, E., Melnick, J. L. & Adelberg, E. A. (2013). Jawetz , Melnik & Adelberg’s Medical Microbiology. 26th edition. New York: London: McGraw-Hill Medical.

Cegielski, J. P., & McMurray, D. N. (2004) "The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals," International Journal of Tuberculosis and Lung Diseases 8:286-298.

Clauss, A. (1999). Rapid physiological coagulation method for the determination of fibrinogen. Acta Haematologica 17: 37-46.

Dacie, J. V. & Lewis, S. M. (2010). Practical Haematology 10th ed. London: ELBS Churchhill Livingstone.

Davalos, D. (2012). Fibrinogen as a key regulator of inflammation in disease Seminars in Immunopathology 34(1):43-62.

Degen, J. L, Bugge, T. H & Goguen, J. D. (2007). Fibrin and fibrinolysis in infection and host defense Journal of Thrombosis and Haemostasis 5:24–31.

Dellinger, R. P, Levy, M. M, Carlet, J. M, Bion, J., Parker, M. M & Jaeschake, R. (2008). Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock Critical Care Medicine 36:296–327.

Esmon, C. T, Xu, J & Lupu, F. (2011). Innate immunity and coagulation Journal of Thrombosis

and Haemostasis 9(1):182–188.

Federal Ministry of Health, Nigeria (2008). National Tuberculosis and Leprosy Control Programme Workers manual 5th edition.

Gawaz, M., Langer, H. & May, A. E. (2005). Platelets in inflammation and atherogenesis Journal of Clinical Investigation 115:3378–84.

Hoffbrand, V. A, Catovssky, D, Tuddenham, G. D. E & Green, A. R. (2011). Postgraduate Haematology Sixth edition Blackwell Publishing Ltd.

Iseman, M. D. (2000). A clinician’s guide to tuberculosis. Philadelphia: Lippincot, Williams and Wilkins.

Löwenberg, E. C, Meijers, J. C. M. & Levi, M. (2010). Platelet-vessel wall interaction in health and disease. Neth Journal of Medicine 68:242–51.

Margetic, S. (2012). Inflammation and haemostasis Biochemia Medica 22(1): 49-62.

Marti-Carvajal, A., Salanti, G. & Cardona, A. F. (2007). Human recombinant activated protein C for severe sepsis. Cochrane Database System Review CD004388.

Mohan M. (2010). Textbook of Pathology 6TH Edition Jaypee Brothers Medical Publishers LTD. Pp 130-154.

Nurden A. T. (2011). Platelets, inflammation and tissue regeneration Thrombosis and Haemostasis 105 (1): S13–S33.

Schouten, M. Wiersinga, W. J., Levi, M. & Poll, T. van der. (2008). Inflammation, endothelium, and coagulation in sepsis Journal of Leukocyte Biology 83:536–545

Speth, C., Loffler, J., Krappmann, S., Lass-Florl, C. & Rambach, G. (2013). Platelets as Immune Cells in Infectious Diseases Future Microbiology 8 (11):1431-1451.

Verhamme, P. & Hoylaerts, M. F. (2009). Haemostasis and inflammation: two of a kind? Thrombosis Journal 7:15.

World Health Organisation /International Union against tuberculosis and lung disease (1998). Grading Guidelines for smear microscopy. Geneva.

World Health Organisation (2012). Global TB Report Retrieved 23rd January, 2013 from www.who.int.

World Health Organisation (2015). Global TB Report. Retrieved 15th September, 2016 from www.who.int.

##submissions.published##

2021-05-20

##issue.issue##

##section.section##

Full Length Research Articles

##plugins.generic.recommendBySimilarity.heading##

##common.pagination##

##plugins.generic.recommendBySimilarity.advancedSearchIntro##