HAEMATOLOGICAL DISPARITIES IN MANTOUX POSITIVE PATIENTS: A COMPARATIVE STUDY OF PULMONARY AND EXTRAPULMONARY TUBERCULOSIS

Abstract

Introduction

Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), which is the infectious illness that is transmitted the most frequently. The study aims to comprehensively evaluate hematological parameters in Mantoux-positive patients diagnosed with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB), and to compare the findings between these two forms of the disease.

Material and Methods

This study was conducted in a private medical college and hospital in Chennai from January 2023 to February 2024, analyzing test samples from outpatient, inpatient, and emergency departments. The research included 48 individuals who tested positive for the Mantoux skin test, categorized into pulmonary and extrapulmonary TB. Haematological manifestations included elevated ESR, leukocytosis, leukopenia, thrombocytosis, and anemia. The study excluded individuals with a history of BCG vaccination, malignant pathologies, infectious diseases, chronic inflammatory conditions, haematological disorders, autoimmune diseases, diabetes mellitus, liver, or kidney diseases, and known hypersensitivity or allergy to tuberculin or its constituents. The study used an automated Sysmex XN 1000 six-part haematology analyzer and the Wintrobe technique to assess ESR in the residual blood.

Results

Our study revealed distinct hematological patterns between pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). PTB patients showed significantly higher neutrophil counts and erythrocyte sedimentation rates (ESR), reflecting a stronger systemic inflammatory response. In contrast, EPTB patients exhibited elevated eosinophil and basophil counts, suggesting site-specific immune activation. Hemoglobin levels, RBC counts, and platelet levels were comparable between the two groups, with no significant differences.

Conclusion

Our study highlights distinct hematological profiles in pulmonary and extrapulmonary tuberculosis, reflecting varied immune responses and emphasizing the need for tailored diagnostic and therapeutic approaches.