A Study of Haematological and Haemostasis Parameters and Hypercoagulable State in Tuberculosis Patients in Northern India and the Outcome with Anti-Tubercular Therapy.

ABSTRACT

INTRODUCTION: Tuberculosis is one of the leading infectious diseases with high morbidity and mortality in the developing countries. Tuberculosis is also rarely associated with hypercoagulable state and very limited literature is available on this association. AIM: To study the haematological and haemostasis laboratory parameters, to correlate the abnormalities for a hypercoagulable state and to study the outcome with anti-tubercular therapy. MATERIALS AND METHODS: The study population included 128 patients with newly diagnosed tuberculosis. Anti-tubercular therapy naïve patients were studied for haemostasis parameters like Prothrombin time, Activated Partial Thromboplastin time, Factor VIII, Fibrinogen and D-dimer and haematological parameters like Haemoglobin, White Blood Cells, Platelet count, Erythrocyte Sedimentation Rate (ESR), Lactate Dehydrogenase, C-reactive protein and albumin. At the end of the second month of anti-tubercular therapy, results were compared and analysed using statistical package for the social sciences software (SPSS). RESULTS: Prothrombin levels were deranged in 50%. Activated Partial Thromboplastin time levels were deranged in 18%. Deranged Factor VIII levels were found in 35.15%. Fibrinogen levels were deranged in 57%. D-Dimer positivity was found in 57.8% patients. Anaemia was found in 75.78%, Leukocytosis in 49.21%, Thrombocytopenia in 37.5% and Hypoalbuminaemia in 75%. ESR levels were raised in 98.43%. Follow up comparison analysis revealed significant p-value for all the parameters except Factor VIII and Activated Partial Thromboplastin time. Similar trend was also observed within different groups of Tuberculosis patients. CONCLUSION: Tuberculosis does favour a hypercoagulable state with increased risk of developing thrombosis and significant improvement with the anti-tubercular treatment alone.