PMID- 37025745
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Mar
TI  - Comparison of Biochemical and Hematological Profiles in Patients of 
      Extrapulmonary and Pulmonary Tuberculosis at a Tertiary Care Center.
PG  - e35778
LID - 10.7759/cureus.35778 [doi]
LID - e35778
AB  - Background Tuberculosis (TB) is a disease of global concern, especially in 
      countries like India. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) differ a 
      lot when it comes to presentations, treatment, and outcomes. The biochemical and 
      hematological test can serve as a marker reflecting the response to treatment in 
      various types of TB, resulting in a better prognosis. Therefore, this study was 
      conducted to compare the biochemical and hematological profiles in patients of 
      extrapulmonary and pulmonary tuberculosis in adults and children. Methods TB 
      cases were divided into four categories: PTB adult, EPTB adult, PTB pediatrics, 
      and EPTB pediatrics. Forty-nine patients in each category were selected, 
      resulting in a total of 196 patients. The sample size was met via convenience 
      sampling. A total of 27 parameters were compared. Mann-Whitney U tests were used 
      for statistical analysis. Results It was observed that serum calcium levels in 
      PTB cases (11.65, 1.15; median and inter-quartile range (IQR), respectively) were 
      significantly different from those in EPTB cases (9.18, 1.03; p<0.001). The 
      median serum sodium levels in EPTB cases (139.49, 6.86) were higher than in PTB 
      cases (130.10, 5.77; p<0.001). For total platelet count levels, a significant 
      difference was observed between PTB (337.00, 180.75) and EPTB cases (278, 159.25; 
      p=0.006). In EPTB cases, the total red blood count (RBC) count levels (4.47, 
      0.96) were higher than in PTB cases (4.24, 0.89; p=0.036). Biochemical and 
      hematological parameters between pediatrics and adult age groups were compared, 
      and it was observed that the median values (IQR) of serum phosphorus, total white 
      blood cells (WBC), and platelet count in pediatric cases were 5.16 (1.09), 14.75 
      (6.03), and 350.00 (155.75), respectively, and were higher from those in adult 
      cases 3.78 (0.97); 8.35 (6.66) and 264 (181.5), respectively (p<0.001). For serum 
      creatinine levels, a significant rise was observed between PTB 0.54 (0.19) and 
      EPTB cases 0.57 (0.16) (p<0.001). It was also observed that alanine transaminase 
      (ALT) levels were higher in adults (18.90 (17.83)) than in the pediatric age 
      group (24.70 (28.67); p=0.042) while alkaline phosphatase (ALP) was higher in the 
      pediatric age group (108.95 (78.37)) than in adults (94.25 (47.92); p=0.003). 
      Conclusion Serum calcium levels and total WBC counts were higher in PTB cases, 
      while the levels of serum sodium and total RBC counts were higher in EPTB cases. 
      ALT, serum phosphorus, total WBC counts, and total platelet counts were higher in 
      the pediatric age group, while ALP, serum urea, and creatinine levels were higher 
      in adults. Increased tissue damage and severity of disease in the pediatric age 
      group, reactive thrombocytosis due to biogenesis in lungs, and abnormal 
      anti-diuretic hormone secretion in PTB cases may be possible explanations for 
      these findings. These findings may help clinicians in the early identification of 
      potential complications, and further studies on these parameters should be 
      conducted.
CI  - Copyright (c) 2023, Shyama et al.
FAU - Shyama, Shyama
AU  - Shyama S
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Ojha, Vishnu S
AU  - Ojha VS
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Biswas, Ratnadeep
AU  - Biswas R
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Luv, Luv
AU  - Luv L
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Kaur, Gurleen
AU  - Kaur G
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Jaiswal, Yash
AU  - Jaiswal Y
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
FAU - Aneef, Asiff N
AU  - Aneef AN
AD  - Internal Medicine, All India Institute of Medical Sciences, Patna, IND.
LA  - eng
PT  - Journal Article
DEP - 20230305
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10071940
OTO - NOTNLM
OT  - adult
OT  - biomarkers
OT  - cross-sectional studies
OT  - extrapulmonary tuberculosis
OT  - hematologic tests
OT  - pediatrics
OT  - pulmonary tuberculosis
OT  - tuberculosis
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/04/08 06:00
MHDA- 2023/04/08 06:01
PMCR- 2023/03/05
CRDT- 2023/04/07 02:34
PHST- 2023/03/03 00:00 [accepted]
PHST- 2023/04/08 06:01 [medline]
PHST- 2023/04/07 02:34 [entrez]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2023/03/05 00:00 [pmc-release]
AID - 10.7759/cureus.35778 [doi]
PST - epublish
SO  - Cureus. 2023 Mar 5;15(3):e35778. doi: 10.7759/cureus.35778. eCollection 2023 Mar.