Changes in haemogram of pulmоnary TB patients during positive clіnical and radiology improvement

Abstract

We studied changes in the complete blood count in 48 patients with infiltrative and disseminated pulmonary tuberculosis before and after treatment against positive clinical and radiographic improvement. The haemogram of patients with tuberculosis varies during the treatment. The mean concentration of haemoglobin in red blood cells and the count of red blood cells in peripheral blood of patients with infiltrative (in 60% of cases) and disseminated (in 45% of cases) tuberculosis increased equally: Hb to 139.5 and 139.3 g/l; RBC to 4.33∙10^12/l and 4.4∙10^12/l, respectively. In 9 (36 ± 9.2%) patients with infiltrative tuberculosis, there was a reduction in the average haemoglobin content in red blood cells of patients to 117.7 g/l, while in disseminated tuberculosis, haemoglobin level did not fall below 132.7 g/l. The obtained results are explained both by a more intensive haematotoxic effect of tuberculosis infection (in case of significant infiltration) and by a toxic adverse effect of prolonged specific chemotherapy, which these patients require. In the haemogram of patients with infiltrative tuberculosis, there was a greater severity of inflammation events, and in disseminated form – of allergic and autoimmune processes. In favourable cases, quantity and quality of blood cells become normal, reflecting the cessation of bacterial excretion, toxicity, and discussion of foci and areas of infiltration. Allergenic or toxic effects of different antibacterial medicines on haematopoiesis cannot be excluded. They often caused eosinophilia, in some cases - leukocytosis, band left shift, lymphocytosis, rarely leukopenia, which may stimulate the lymphoid and reticular reaction. The results indicate the feasibility to add TB chemotherapy with cytoprotective medicines.