Comparison of platelet count in tuberculosis spine to other spine pathology

Daniel, Koshy; Dunn, Robert

doi:10.1007/s00586-013-2859-5

Cited by 7 publications

(9 citation statements)

References 12 publications

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“…Fifty-seven per cent of adults in the current study were female, a finding in keeping with previous spinal TB studies from South Africa [7, 8, 25, 26] but in contrast to other large studies in which 51–61% of spinal TB cases were male [4, 11, 12, 24]. One possible explanation for this difference is HIV infection and its oft-cited association with extra-pulmonary TB disease [27, 28].…”

Section: Discussionsupporting

confidence: 91%

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

et al. 2018

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The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6–4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.

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Section: Discussionsupporting

confidence: 91%

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

et al. 2018

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“…Therefore ESR is still recommended as a useful diagnostic clue and indicator of response to treatment, even in HIV positive patients. 48 …”

Section: Resultsmentioning

confidence: 99%

“…A raised CRP has been observed in between 90% and 100% of STB cases but, as with the ESR, it is not specific to STB and may indicate some other inflammatory or infective process. 9 , 19 , 29 , 48 In addition, a raised platelet count has been observed in people with STB, in both those infected and uninfected with HIV. 48 Therefore ESR, CRP and platelet count are useful tests to assist in the clinical reasoning around a patient presenting with spinal pain, suggesting that an infective process is present.…”

Section: Resultsmentioning

confidence: 99%

“…White cell count, haemoglobin and alkaline phosphatase: A normal WCC is typical in STB, indicating that the spinal infection is less likely to be pyogenic in nature, and an anaemic picture is common in the majority of STB presentations. 4 , 27 , 29 , 48 An elevated alkaline phosphatase may also suggest the presence of STB. However, based on the small sample this result was reported in (21 cases), we cannot make a strong recommendation on its use.…”

Section: Resultsmentioning

confidence: 99%

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Could an increase in vigilance for spinal tuberculosis at primary health care level, enable earlier diagnosis at district level in a tuberculosis endemic country?

Galloway¹,

Parker

2018

Afr. j. prim. health care fam. med.

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BackgroundExpert clinicians and researchers in the field of spinal tuberculosis (STB) advocate for early identification and diagnosis as a key to reducing disability, severity of disease, expensive surgery and death, especially in tuberculosis (TB) endemic countries like South Africa. South Africa has the highest incidence per capita of tuberculosis in the world, and a conservative estimate of the incidence of STB in South Africa is 8–16:100 000. People living with STB may initially present to primary health care (PHC) centres, where the opportunity exists for early identification. Spinal pain is the most common presentation of STB, but even this symptom may not be present. Occasionally the only symptoms are neurological injury, dysphagia or referred pain. Computerised tomography-guided biopsy remains the diagnostic gold standard for STB.AimA narrative review was undertaken to investigate the evidence available that could assist with the early diagnosis of STB.MethodArticles were searched for and retrieved from three databases and assessed for quality and relevance to primary settings in a TB endemic country.ResultsThe following evidence-based, affordable and available tools could facilitate early diagnosis of STB at PHC and district hospital levels: (1) back pain screening questions, undressed spinal physical examination, HIV and antiretroviral therapy history, (2) erythrocyte sedimentation rate, C-reactive protein, platelets, haemoglobin, white cell count (WCC), sputum for GeneXpert and accurate weight measurement, (3) physiotherapy and/or medical and/or speech therapy assessment, (4) full spinal radiograph, chest radiograph, abdominal ultrasound, urine lipoarabinomannan (LAM) if CD4 < 200 and ultrasound-guided biopsy of superficial abscesses, (5) clear referral guidelines at all levels, (6) a positive response to treatment to confirm the diagnosis.ConclusionThese affordable and simple actions at PHC and district levels could facilitate earlier diagnosis of STB.

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“…Namun masih terdapat perbedaan pendapat mengenai akurasi dan sensitivitas pemeriksaan LED dan CRP di dalam memonitor pasien-pasien positif Tb. [15][16][17][18] LED merupakan tes non spesifik yang nilainya berkaitan dengan perubahan nilai protein plasma. Pada infeksi, inflamasi, degeneratif dan keganasan, nilainya akan meningkat, seperti halnya peningkatan nilai fibrinogen, imunoglobulin dan CRP.…”

Section: Pendahuluanunclassified

Hubungan pemeriksaan LED dan CRP pada penegakkan diagnosis Spondilitis Tb di RSUP dr. M. Djamil Padang tahun 2014-2016

et al. 2018

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Spondilitis Tuberkulosis (Tb) merupakan manifestasi Tb tulang yang paling berbahaya dan paling sering ditemukan. Perubahan nilai hematologi berupa pengukuran nilai Laju Endap Darah (LED) dan C-Reactive Protein (CRP) digunakan dalam penegakkan diagnosa, penilaian prognosis dan efektivitas pengobatan Spondilitis Tb. Tujuan: Untuk mengetahui hubungan dan akurasi diagnostik LED dan CRP pada pasien spondilitis Tb. Metode: Penelitian ini menggunakan desain retrospective cohort study pada 53 penderita diduga Spondilitis Tb yang belum pernah mendapatkan terapi OAT, tetapi telah menjalani operasi dan pemeriksaan histopatologi pada periode Januari 2014 hingga Desember 2016, di RSUP dr. M. Djamil Padang dan diolah dengan analisis Fisher’s Exact Test. Hasil: Tidak terdapat hubungan yang bermakna antara kejadian Spondilitis Tb dan nilai LED dengan p-value 0,280 (p>0,05). Tidak terdapat hubungan yang bermakna antara kejadian Spondilitis Tb dengan nilai kualitatif CRP dengan p-value 0,886 (p>0,05). Simpulan: Berdasarkan hasil tersebut, dapat disimpulkan bahwa pemeriksaan LED dan CRP tidak spesifik untuk diagnosis Spondilitis Tb, kecuali CRP memiliki sensitivitas yang tinggi.

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Comparison of platelet count in tuberculosis spine to other spine pathology

Cited by 7 publications

References 12 publications

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

Could an increase in vigilance for spinal tuberculosis at primary health care level, enable earlier diagnosis at district level in a tuberculosis endemic country?

Hubungan pemeriksaan LED dan CRP pada penegakkan diagnosis Spondilitis Tb di RSUP dr. M. Djamil Padang tahun 2014-2016

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