Title : Hematological changes in patients with pulmonary tuberculosis before and after treatment
Abstract:
Tuberculosis (TBC) causes, in addition to inflammation, multiple and varied hematological abnormalities causing multiple vascular accidents. The aim of our study was to describe the hematological abnormalities in patients with pulmonary TBC and their evolution after treatment.Eighty-two patients with pulmonary TBC were included in our prospective study from March 2021 to March 2023, with an average age of 25.72 ± 5.25 years; 97.6% of our sample was male.Biologically, on the blood count, 24.4% of patients had leukocytosis, 22% had polynucleosis, 14.6% had lymphopenia, and 28% had monocytosis. Anemia was present in 64.6% of patients; this anemia was moderate in 13.2% and severe in 1.9% of cases. It was of the normocytic normochromic type in 62.2% of patients. Thrombocytosis was present in 23.2% and thrombocytopenia in 4.9%. The sedimentation rate (ESR) was high in 90% of tuberculosis patients, CRP was positive in 93.7% of cases, fibrinogen was greater than 4 g/L in 92.6% of patients, and LDH was elevated in only 52.6% of the sample. The hemostasis assessment was also disturbed: the prothrombin time (PT) was low in 32.1% of tuberculosis patients, the activated partial thromboplastin time (aPTT) was prolonged in 60.8%, and the dosage of D-dimers was greater than 500 µg/L in 84% of patients. The clinical and biological evolution was favorable in most of the patients included. The blood count normalized in two-thirds of the sample after one month of treatment, as did ESR, CRP, LDH, PT, aPTT, and D-dimers. However, normalization of fibrinogen took longer, until the second month of treatment. Monitoring of hematological abnormalities can be used for surveillance of the evolution of TBC and the effectiveness of the treatment.
