Haemorheologic and Fibrinolytic Activities of Pulmonary Tuberculosis Patients in Calabar, Cross River State, Nigeria.

Abstract

Pulmonary tuberculosis (PTB) is a major infectious disease with very high prevalence in Nigeria which may increase with the incidence of HIV infection. Severe pulmonary tuberculosis is often complicated by deep vein thrombosis (DVT) because of the association between inflammation and haemostatic changes that can result in an acute phase response and a hypercoagulable state. This research was undertaken to provide information on the haemorheologic and fibrinolytic activities of Nigerian pulmonary tuberculosis patients. A total of one hundred pulmonary tuberculosis patients, (fifty two males and forty eight females) aged 15-45 years, attending the tuberculosis clinics at Dr. Lawrence Henshaw Memorial Hospital and University of Calabar Teaching Hospital, Calabar were investigated. Twenty two of these patients were sero-positive for human immunodeficiency virus (HIV) while seventy eight were sero-negative. Seventy apparently healthy subjects, age and gender matched were used as controls. Erythrocyte sedimentation rate (ESR), relative plasma viscosity (RPV), euglobulin lysis time (ELT) and plasma fibrinogen concentration were estimated using standard methods. Results showed significant increase in ESR, RPV, ELT and fibrinogen levels (P<0.05) approaching normal values as therapy progressed. The ESR of the sero-positve tuberculosis subjects was significantly higher (p<0.05) when comparison was made with tuberculosis subjects who were sero-negative for HIV. This work has shown abnormal rheology and impaired fibrinolysis in tuberculosis patients. A combination of these two abnormalities may predispose pulmonary tuberculosis patients to thrombosis and vascular complications. For better treatment and monitoring of response to therapy of tuberculosis patients, it is recommended that plasma viscosity, euglobulin lysis time test and fibrinogen concentration should be part of the routine tests.

Keywords: Pulmonary tuberculosis, haemorheology, fibrinolysis, thrombosis.