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Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa  [PDF]
Christophe Mbombo Mulenga, Jean-Marie Ntumba Kayembe, Benoit Obel Kabengele, Alain Bakebe
Journal of Tuberculosis Research (JTR) , 2017, DOI: 10.4236/jtr.2017.54026
Abstract: Context: The burden of TB in Africa tends to be exacerbated by the socio-economic situation and the high prevalence of intercurrent infections such as HIV, malaria and non-specific bacterial infections. These factors often result in anemia, making patients at high risk for anemia. Objective: We aimed to gain insights into the characteristics of anemia, hematologic variations and socio-economic status in untreated pulmonary TB patients (PTB) in Kinshasa, the Democratic Republic of Congo. Methods: We conducted a cross-sectional analysis of 200 smear-positive pulmonary TB patients (PTB) recruited at the initiation of TB treatment. Complete Blood Count, Iron profile, BMI, CRP and albuminemia were assessed. Data were analyzed using Student t or Mann Whitney tests as appropriate, and logistic regression was performed to assess the strength of associations. Results: Anemia was a regular finding in (69%). This anemia was mostly moderate (92.2%) and with iron deficiency pattern (48%). Hypoalbuminemia was observed in half of the subjects and appears to be correlated with the severity of anemia. Surprisingly, the severity of inflammation, as reflected by the CRP, was inversely correlated with the anemia. In the multivariate analysis, alcohol intake (OR: 2.38; IC 95%: 1.05 - 5.38), hypoalbuminemia (OR: 1.98; IC 95%: 1.02 - 3.82) and CRP rate were significantly associated with the presence of anemia among pulmonary tuberculosis at the diagnostic. Conclusion: This study demonstrates the heavy burden of the iron responsive anemia and risky life conditions in newly diagnosed TB patients, and underscores the potential usefulness of iron supplementation in the Congolese context.
Significance of serum neopterin level in diagnosis of active pulmonary tuberculosis
Xue-ping SHI,Qimanguli Wushouer,Quan WANG,Li JIE
Medical Journal of Chinese People's Liberation Army , 2011,
Abstract: Objective To investigate the sensitivity and specificity of serum neopterin(Np) level in diagnosis of active pulmonary tuberculosis.Methods Patients with pulmonary tuberculosis,admitted to Xinjiang Chest Hospital from Apr.2009 to May 2010,were consecutively enrolled in present study.Serum neopterin level was determined with enzyme linked immunosorbent assay(ELISA) in the next morning of admission.VCG purified protein derivative test(PPD) was concurrently performed.Results Fifty-eight cases with active(group A) and 18 with stable(group S) pulmonary tuberculosis were recruited,and 32 healthy volunteers served as control(group C).The mean Np level was significantly higher in group A(54.14±19.85 nmol/L) than in group S(29.51±8.23 nmol/L) and group C(20.67±9.68 nmol/L,P < 0.01).No statistical difference was found between group S and group C(P > 0.05).Among patients with active pulmonary tuberculosis,the mean Np level increased significantly in cases with the fibro-cavitative pulmonary tuberculosis(77.43±22.13),compared with those cases with invasive(46.07±13.04) and hematogenous disseminated pulmonary tuberculosis(48.48±8.34 nmol/L,P < 0.01),while no statistical difference existed between the latter two.The receiver operating characteristic(ROC) curve showed that the area under curve(AUC) was 0.951 in the cutoff value of 36.73 nmol/L,and the sensitivity and specificity were 86% and 92% for predicting active pulmonary tuberculosis,and it was significantly higher than PPD test(P < 0.01),in which the sensitivity was 52% and specificity was 78%.Conclusions Np level may serve as one of the important adjunctive parameters for early diagnosis of active pulmonary tuberculosis due to its high sensitivity and specificity.
Stevanovic G,,Pelemis M,,Pavlovic M,,Lavadinovic L
Journal of IMAB : Annual Proceeding (Scientific Papers) , 2011,
Abstract: Extra pulmonary tuberculosis (EPTB) is a growing problem worldwide. Due to the nature of the disease, the diversity of clinical pictures as well as its minor epidemiological importance, the diagnosis is difficult and often late.In addition to standard TB diagnostic techniques use of new biochemical (surrogate markers) are increased. With this work we wanted to examine the usefulness of serum adenosine deaminase levels as a diagnostic parameter for EPTB.The work included 116 patients with fever of unknown origin in which tuberculosis or infectious mononucleosis was not proven and 51 person who had proven EPTB. Correlated adenosine deaminase levels between these two groups we obtained significantly higher values in patients with EPTB. The calculated sensitivity was 0.56, specificity 0.89, positive predictive value 0.80 and negative predictive value 0.72. Certain reducing of the values observed during anti TB therapy. In previous studies the diagnostic importance of adenosine deaminase in the diagnosis of tuberculosis serosityes was demonstrated. The significance of serum levels in diagnosis is rarely evaluated during EPTB. Our findings are similar to the results of authors who have conducted such testing in the pediatric population.Increased concentrations of serum adenosine deaminase have shown the potential of usable screening test and can be used as an indicative EPTB parameter. To fully assess its diagnostic significance require future clinical research.
Altered serum microRNAs as biomarkers for the early diagnosis of pulmonary tuberculosis infection  [cached]
Qi Yuhua,Cui Lunbiao,Ge Yiyue,Shi Zhiyang
BMC Infectious Diseases , 2012, DOI: 10.1186/1471-2334-12-384
Abstract: Background Pulmonary tuberculosis (TB) is a highly lethal infectious disease and early diagnosis of TB is critical for the control of disease progression. The objective of this study was to profile a panel of serum microRNAs (miRNAs) as potential biomarkers for the early diagnosis of pulmonary TB infection. Methods Using TaqMan Low-Density Array (TLDA) analysis followed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) validation, expression levels of miRNAs in serum samples from 30 patients with active tuberculosis and 60 patients with Bordetella pertussis (BP), varicella-zoster virus (VZV) and enterovirus (EV) were analyzed. Results The Low-Density Array data showed that 97 miRNAs were differentially expressed in pulmonary TB patient sera compared with healthy controls (90 up-regulated and 7 down-regulated). Following qRT-PCR confirmation and receiver operational curve (ROC) analysis, three miRNAs (miR-361-5p, miR-889 and miR-576-3p) were shown to distinguish TB infected patients from healthy controls and other microbial infections with moderate sensitivity and specificity (area under curve (AUC) value range, 0.711-0.848). Multiple logistic regression analysis of a combination of these three miRNAs showed an enhanced ability to discriminate between these two groups with an AUC value of 0.863. Conclusions Our study suggests that altered levels of serum miRNAs have great potential to serve as non-invasive biomarkers for early detection of pulmonary TB infection.
Role of Serum Procalcitonin Level in Differentiating between Pulmonary Tuberculosis and Community-Acquired Pneumonia  [PDF]
Mohammad Shameem, Mazhar Alam, Shagufta Moin, Rakesh Bhargava, Zuber Ahmad, Jamal Akhtar
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.515121

Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP) are common causes of consolidation patch in chest radiograph. Sputum Z-N staining is positive in 30% to 60% cases only and sputum examination has poor yield in CAP. This study aimed to assess the value of serum Procalcitonin (PCT) levels in patients with Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP). Patients with new opacity in chest radiograph were included in the study. Serum sample were taken at admission and stored. Patient’s diagnosis were confirmed and categorized into pulmonary TB group (32) and community-acquired pneumonia group (23). Their mean PCT level was compared with mean PCT level of 25 controls. Serum procalcitonin levels were found to be significantly elevated in patients of community-acquired pneumonia as compared to patients of pulmonary tuberculosis. In presence of consolidation in x-ray chest, increased level of serum procalcitonin might be used to differentiate pulmonary tuberculosis from community-acquired pneumonia. High level of serum procalcitonin was associated with high mortality rate in community-acquired pneumonia patients.

Effect of Antituberculosis Regimen Containing Ethambutol on Serum magnesium Level in Pulmonary Tuberculosis Patients
Mohammad Abbasi Nazari,Farzad Kobarfard,Payam Tabarsi,Maryam Azimi
Iranian Journal of Pharmaceutical Research , 2009,
Abstract: Magnesium is an essential metal that has important roles in physiological function of the body organs. Ethambutol is an oral antitubercular agent with chelating effects owing to its chemical structure. The aim of present study is to determine whether ethambutol usage can alter serum magnesium concentration in patients with pulmonary tuberculosis. Sixty patients with diagnosis of pulmonary tuberculosis were enrolled in the study. Blood samples were obtained before treatment from patients. Ten days after starting anti tuberculosis therapy, second blood samples were obtained. The amounts of serum magnesium were determined in all samples by spectrophotometric method. Statistical analysis showed that serum magnesium concentrations at baseline (0.61±0.08 mmol/l) and at day 10 (0.62±0.11 mmol/l) were not different. It is possible that ethambotol does not affect magnesium concentration in tuberculosis patients, however further studies about the other cationic trace elements are recommended.
Elucidating Novel Serum Biomarkers Associated with Pulmonary Tuberculosis Treatment  [PDF]
Mary A. De Groote, Payam Nahid, Leah Jarlsberg, John L. Johnson, Marc Weiner, Grace Muzanyi, Nebojsa Janjic, David G. Sterling, Urs A. Ochsner
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0061002
Abstract: In an unbiased approach to biomarker discovery, we applied a highly multiplexed proteomic technology (SOMAscan, SomaLogic, Inc, Boulder, CO) to understand changes in proteins from paired serum samples at enrollment and after 8 weeks of TB treatment from 39 patients with pulmonary TB from Kampala, Uganda enrolled in the Center for Disease Control and Prevention’s Tuberculosis Trials Consortium (TBTC) Study 29. This work represents the first large-scale proteomic analysis employing modified DNA aptamers in a study of active tuberculosis (TB). We identified multiple proteins that exhibit significant expression differences during the intensive phase of TB therapy. There was enrichment for proteins in conserved networks of biological processes and function including antimicrobial defense, tissue healing and remodeling, acute phase response, pattern recognition, protease/anti-proteases, complement and coagulation cascade, apoptosis, immunity and inflammation pathways. Members of cytokine pathways such as interferon-gamma, while present, were not as highly represented as might have been predicted. The top proteins that changed between baseline and 8 weeks of therapy were TSP4, TIMP-2, SEPR, MRC-2, Antithrombin III, SAA, CRP, NPS-PLA2, LEAP-1, and LBP. The novel proteins elucidated in this work may provide new insights for understanding TB disease, its treatment and subsequent healing processes that occur in response to effective therapy.
Evaluation of Serum Levels of Essential Trace Elements in Patients with Pulmonary Tuberculosis Before and After Treatment by Age and Gender
F. Pourfallah,S. Javadian,Z. Zamani,R. Saghiri
Pakistan Journal of Biological Sciences , 2011,
Abstract: The purpose of this study was to evaluate the levels of Zinc, Copper, Iron and Copper/Zinc ratio in the serum of adult patients with pulmonary tuberculosis in Iran. Serum levels of Zinc and Copper were determined by flame atomic absorption spectrophotometer and serum iron concentration was measured by using an Auto Analyzer. The study group consisted of 50 pulmonary tuberculosis patients before treatment and after 6 months of anti-tubercular therapy. Levels of serum Zn (p<0.001) and Fe (p<0.001) in TB patients were significantly increased after 6 months of anti-tubercular therapy. However, serum Cu concentration (p<0.01) and Cu/Zn ratio (p<0.05) were decreased after 6 months of anti-tubercular therapy. Some studies indicated a strong association of Zn, Cu, Fe and the Cu/Zn ratio with TB. In this study, we found remarkable change in Cu/Zn ratio. Some researchers mentioned that serum Cu/Zn ratio could be used as an important laboratory marker for diagnosis and treatment of tuberculosis. They also mentioned that trace element levels must be closely monitored during the process of disease.
Screening and Identification of Six Serum microRNAs as Novel Potential Combination Biomarkers for Pulmonary Tuberculosis Diagnosis  [PDF]
Xing Zhang, Jing Guo, Shufeng Fan, Yanyuan Li, Liliang Wei, Xiuyun Yang, Tingting Jiang, Zhongliang Chen, Chong Wang, Jiyan Liu, Zepeng Ping, Dandan Xu, Jiaxiong Wang, Zhongjie Li, Yunqing Qiu, Ji-Cheng Li
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0081076
Abstract: Background It is very difficult to prevent pulmonary tuberculosis (TB) due to the lack of specific and diagnostic markers, which could lead to a high incidence of pulmonary TB. We screened the differentially expressed serum microRNAs (miRNAs) as potential biomarkers for the diagnosis of pulmonary TB. Methods In this study, serum miRNAs were screened using the Solexa sequencing method as the potential biomarkers for the diagnosis of pulmonary TB. The stem-loop quantitative reverse-transcription polymerase chain reaction (qRT-PCR) assay was used to verify differentially expressed serum miRNAs. The receiver operating characteristic (ROC) curve and logistic regression model were used to analyze the sensitivity and specificity of the single miRNA and a combination of miRNAs for diagnosis, respectively. Using the predicted target genes, we constructed the regulatory networks of miRNAs and genes that were related to pulmonary TB. Results The Solexa sequencing data showed that 91 serum miRNAs were differentially expressed in pulmonary TB patients, compared to healthy controls. Following qRT-PCR confirmation, six serum miRNAs (hsa-miR-378, hsa-miR-483-5p, hsa-miR-22, hsa-miR-29c, hsa-miR-101 and hsa-miR-320b) showed significant difference among pulmonary TB patients, healthy controls (P<0.001) and differential diagnosis groups (including patients with pneumonia, lung cancer and chronic obstructive pulmonary disease) (P<0.05). The logistic regression analysis of a combination of six serum miRNAs revealed that the sensitivity and the specificity of TB diagnosis were 95.0% and 91.8% respectively. The miRNAs-gene regulatory networks revealed that several miRNAs may regulate some target genes involved in immune pathways and participate in the pathogenesis of pulmonary TB. Conclusion Our study suggests that a combination of six serum miRNAs have great potential to serve as non-invasive biomarkers of pulmonary TB.
The relative role of serum albumin and urinary creatinine as biochemical indices for Nigerians with pulmonary tuberculosis
S. A. Adebisi, P. O. Oluboyo, O. Oladipo
African Journal of Clinical and Experimental Microbiology , 2003,
Abstract: Objective: The objective is to evaluate roles of urinary creatinine and serum albumin as biochemical markers for monitoring the nutritional status of pulmonary tuerculosis patients during treatment. Design: This was a longitudinal study. Each patient was studied for six months. Settings: This study was carried out at University of Ilorin Teaching Hospital. Subjects: Forty-five newly diagnosed patients with pulmonary tuberculosis were used for the study. Intervention (Method): Forty-five newly diagnosed pulmonary tuberculosis patients were placed on six months short course regimen. Their weight, Body mass index, serum albumin and 24-hour urinary creatinine were determined before treatment, at the end of the 1st, 2nd, 4th and 6th month of treatment. Using ANOVA, the mean values of the weight, BIM and serum albumin were analysed with further analysis paired student T- test of the pre-treatment values with end of 6th month values. Main outcome measured: Their weight, body mass index, serum Albumin and 24-hour urinary creatinine were determined. Results: Thirty-one patients with mean age of 36.8 years completed the study. The pretreatment mean weight, body mass index, serum albumin were 49.53kg, 17.72kg/m2 and 26.7g/L respectively. The corresponding values at the end of the sixth month of treatment were 57.03kg. 20.4kgm2 and 39.97g/L. These three variables showed significant upward improvements. Conclusion: Both the body mass index and serum Albumin pretreatment values showed that the patients were malnourished at presentation. Serum albumin being more sensitive and more reliable than both weight and body mass index as revealed by this recommended as index for nutritional assessment in patient with tuberculosis. (Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 72-77)
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