Effect of pulmonary tuberculosis on natural anticoagulant activity in therapy-naïve Ghanaian adults; a case-control study

ABSTRACT

Tuberculosis constitutes a global emergency as it affects one-third of the world’s inhabitants. Although Pulmonary tuberculosis (PTB) is curable, immunological responses to the infection induce several hematological derangements. This study evaluated the effect of PTB on natural anticoagulant activity and CBC indices. Ninety adults were recruited: 60 PTB patients and 30 non-TB controls. Blood specimens from each participant was tested for Proteins C and S, Antithrombin-III and CBC. Pulmonary TB was associated with significantly reduced Protein C activity (101.46 [87.61–128.3] vs 121.44 [99.50–149.8] IU/L, p= 0.038), RBC (p< 0.0001), HgB (p= 0.0019), HCT (p< 0.0001), MCV (p= 0.0133) and PDW (p< 0.0001) compared to controls. Conversely, PTB patients were associated with significantly increased MCH (p= 0.0086), TWBC (p= 0.0047), Abs. GRAN (p= 0.0226), RDW-CV (p< 0.0001), MCHC (p< 0.0001) and MPV (p= 0.0027) compared to controls. The PTB patients were disproportionately affected with anemia (91.7%, p= 0.001), erythrocytopenia (75.0%, p≤ 0.001) and reduced HCT (80.0%, p≤ 0.001). The frequency of thrombocytosis, leucocytosis, and granulocytosis (50.0%, p= 0.013; 23.3%, p= 0.013; 18.3%, p= 0.025; respectively) in PTB patients were significantly higher than in controls. PTB predisposes to hypercoagulability and causes derangements in erythrocytes, leucocytes, and thrombocytes, and disproportionately causes anemia. Measurement of Protein C activity and CBC indices are useful in the management of PTB patients.

KEYWORDS:

• Hematological profile
• hypercoagulability
• Protein C
• Protein S
• pulmonary tuberculosis

Acknowledgments

We are grateful to Miss Barbara Aggrey and the entire staff of Nkawie-Toase Government Hospital Laboratory for their support. Also, we appreciate all participants for their patience and cooperation.

Data Availability

The datasets generated and or analyzed during the current study are available in the Harvard Dataverse repository, https://doi.org/10.7910/DVN/6MMBSA.

Disclosure statement

No potential conflict of interest was reported by the author(s).

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Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.