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Title: Pulmonary tuberculosis induces a systemic hypercoagulable state
Authors: Liesbeth M. Kager
Dana C. Blok
Ivar O. Lede
Wahid Rahman
Rumana Afroz
Paul Bresser
Jaring S. van der Zee
Aniruddha Ghose
Caroline E. Visser
Menno D. de Jong
Michael W. Tanck
Abu Shahed M. Zahed
Khan Mashrequl Alam
Mahtabuddin Hassan
Ahmed Hossain
Rene Lutter
Cornelis van t. Veer
Arjen M. Dondorp
Joost C.M. Meijers
Tom van der Poll
Academic Medical Centre, University of Amsterdam
Department of Pulmonology
Chittagong Medical College Hospital
Chittagong Medical College
Chest Disease Clinic Chittagong (CDCC)
Mahidol University
University of Oxford
Keywords: Medicine
Issue Date: 1-Apr-2015
Citation: Journal of Infection. Vol.70, No.4 (2015), 324-334
Abstract: © 2014 The British Infection Association. Objectives: Human tuberculosis (TB) remains an important cause of death globally. Bangladesh is one of the most affected countries. We aimed to investigate the impact of pulmonary TB on pro- and anticoagulant mechanisms. Methods: This prospective study was conducted in Chittagong, Bangladesh. We performed an in-depth analysis of coagulation activation and inhibition in plasma obtained from 64 patients with primary lung TB and 11 patients with recurrent lung TB and compared these with 37 healthy controls. Additionally, in nine patients coagulation activation was studied in bronchoalveolar lavage fluid (BALF) harvested from the site of infection and compared with BALF from a contralateral unaffected lung subsegment. Results: Relative to uninfected controls, primary and recurrent TB were associated with a systemic net procoagulant state, as indicated by enhanced activation of coagulation (elevated plasma levels of thrombin-antithrombin complexes, D-dimer and fibrinogen) together with impaired anticoagulant mechanisms (reduced plasma levels of antithrombin, protein C activity, free protein S, and protein C inhibitor). Activation of coagulation did not correlate with plasma concentrations of established TB biomarkers. Coagulation activation could not be detected at the primary site of infection in a subset of TB patients. Conclusions: Pulmonary TB is associated with a systemic hypercoagulable state.
ISSN: 15322742
Appears in Collections:Scopus 2011-2015

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