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Smear-negative pulmonary tuberculosis and lymphocyte subsets
Shah Muhammad Khan Jadoon1, Shaheen Moin, Tahir Aziz Ahmed
1Department of Medicine, The School of Infantry and Tactics, Quetta, Pakistan. drsmkjadoon@yahoo.com
Objective:
To correlate and quantitate lymphocyte subsets with clinically diagnosed smear-negative pulmonary tuberculosis and severity of disease.
Design:
Case-control study.
Place And Duration Of Study:
Military Hospital and Armed Forces Institute of Pathology Rawalpindi. 1999-2000.
Subjects And Methods:
Freshly diagnosed, well-characterized smear-negative patients (n=15) of pulmonary tuberculosis were selected. Non-induced three-consecutive negative smears of sputum with simultaneous culture for AFB for 6-8 weeks, positive Mauntoux test (Z10 mm), blood complete picture with ESR and chest x-rays were done. Selected panel of monoclonal antibodies against specific CD markers were used. Statistical analysis done by student t-test or Mann-Whitney rank-sum test with the help of Sigma State software.
Results:
Hemoglobin and total lymphocyte counts were significantly reduced whereas total leukocyte counts with absolute neutrophil counts were increased. Fraction of CD4+ and CD8+ T lymphocytes with HLA-DR expression was reduced while no significant change in rest of the TB and NK lymphocytes.
Conclusion:
Low hemoglobin level, high neutrophil count and low total lymphocytes suggest possible direct relationship with extent of disease. The number of activated CD4+, CD8+, ab and gd TCR T cells have tendency to increase during Mycobacterium infection. This seems to have a potential of being a good, non-invasive prognostic indicator for patients with pulmonary tuberculosis.