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[A study on relation between active pulmonary tuberculosis and underlying diseases].

M Tamura1, R Shirayama, R Kasahara

  • 1Department of Internal Medicine, Nishinara National Hospital, Japan.

Kekkaku : [Tuberculosis]
|October 26, 2001
PubMed
Summary

Underlying diseases like diabetes mellitus significantly impact active pulmonary tuberculosis, increasing severity and delaying recovery. Better blood sugar control in diabetic patients correlates with reduced tuberculosis progression.

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[A study of factors relating to aggravation of patients with pulmonary Mycobacterium avium complex disease--with special reference to malnutrition].

Kekkaku : [Tuberculosis]·1999

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Endocrinology

Background:

  • Active pulmonary tuberculosis (TB) is a global health concern.
  • The influence of comorbid underlying diseases on TB progression is not fully understood.
  • Identifying key comorbidities can inform patient management and treatment strategies.

Purpose of the Study:

  • To investigate the relationship between active pulmonary tuberculosis and the presence of underlying diseases.
  • To determine the impact of specific comorbidities, such as diabetes mellitus, on TB severity and treatment outcomes.

Main Methods:

  • Retrospective study of 119 patients with active pulmonary tuberculosis.
  • Analysis of patient data including demographics, comorbidities, sputum smear/culture results, chest X-rays, and serum albumin levels.

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  • Comparison of clinical characteristics and treatment outcomes between patients with and without underlying diseases, and stratified analysis based on specific comorbidities and glycemic control.

    • Main Results:

    • A high prevalence (73.1%) of underlying diseases was observed in TB patients.
    • Diabetes mellitus was the most common comorbidity (39.1%), followed by chronic hepatitis C, sequelae of cerebral infarction, hypertension, and gastric ulcer.
    • Patients with underlying diseases exhibited higher mean age, increased sputum smear positivity, lower albumin levels, and longer culture conversion times.
    • Poorly controlled diabetes (HbA1c ≥ 9%) was associated with increased smear positivity, lower albumin, and prolonged culture conversion.
    • Low albumin levels (< 3 g/dl) in diabetic TB patients also correlated with longer culture conversion times.
    • Underlying diseases and nutritional status (low albumin) were linked to decreased tuberculous immunity, affecting TB onset and progression.

    Conclusions:

    • Underlying diseases significantly impact the clinical presentation, severity, and treatment outcomes of active pulmonary tuberculosis.
    • Diabetes mellitus, particularly when poorly controlled, exacerbates TB severity and complicates recovery.
    • Maintaining adequate nutritional status and managing comorbidities are crucial for improving immune response and TB treatment efficacy.