Markers of acute-phase response in the treatment of pulmonary tuberculosis

Abstract

Introduction: Tuberculosis promotes an acute phase response with an increase of blood reactants, such as C-reactive protein (CRP), among others, which are associated with increased erythrocyte sedimentation rate (ESR). Objective: Evaluate the ESR and the CRP as markers for diagnosis and monitoring cases of pulmonary tuberculosis. Method: Research on patients with clinical, laboratory, and imaging diagnosis of pulmonary tuberculosis, from Itajaí-SC; in which CRP and ESR were analyzed in three different times: at diagnosis, before starting treatment (T0), after three months of treatment (T1), and at the end of treatment (T2). Results: 51 patients were studied at T0 (100%), 43 (84.31%) at T1, and 32 (62.74%) at T2. ESR and CRP values presented significant differences in the three different times (p < 0.0001∗∗∗). When analyzing the relationship between negative/positive sputum and altered/normal ESR and CRP at T0, ESR (p = 0.0691), CRP (p = 0.0166∗). For chest imaging and sputum smear variables it was observed the following: CRP versus smear (p = 0.0002∗∗∗), ESR versus smear (p = 0.3810), CRP versus chest imaging (p = 0.0097∗∗), and ESR versus chest imaging (p = 0.0766). The correlation between ESR and CRP was: T0 (p = 0.0033∗∗), T1 (p < 0.0001∗∗∗) and T2 (p = 0.0015∗∗). Conclusion: ESR and CRP proved to be good markers in the diagnosis and monitoring of tuberculosis cases, however, CRP achieve more significant results than ESR.