[A systemic inflammatory response in teenagers with new-onset tuberculosis]

Fifty-eight adolescents aged 13-17 years who had new-onset pulmonary tuberculosis were examined. The serum levels of C-reactive protein (CRP), alpha-antitrypsin (alpha1-AT), haptoglobin (Hp), serum protein fractions, medium-weight molecules (MWM), and malonic dialdehyde (MDA) were assayed in the patients on admission, 2 weeks, and 1, 2, 3, and 6 months after treatment. The parameters of a systemic inflammatory response were ascertained to naturally vary in the adolescents with new-onset tuberculosis, by reflecting as both a defense reaction (increases in the levels of CRP, a,-AT, Hp) and as metabolic decompensation manifestations (increases in the concentrations of MWM and MDA and a reduction in the almubin/globulin (A/G) ratio. The magnitude of these changes makes it possible to judge the severity of a process to a certain extent and it is unassociated with the genesis of the disease. The levels of acute-phase reagents and MDA undergo positive changes just 2 weeks of effective specific chemotherapy whereas there are no changes after ineffective treatment. After correction of chemotherapy and achieving a clinical effect, there was a complete normalization in the levels of CRP, Hp, and A/G ratio, but a slight increase in alpha1-AT and MDA in all the children by month 6 of therapy. In all the adolescents, the baseline increased concentration of MWM increased at the early stage of chemotherapy and returned to the original value after 6-month therapy, by remaining significantly higher than the normal values.