Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio

Nakao, Makoto; Muramatsu, Hideki; Arakawa, Sosuke; Sakai, Yusuke; Suzuki, Yuto; Fujita, Kohei; Sato, Hisaaki

doi:10.1016/j.resinv.2018.08.007

Cited by 27 publications

(20 citation statements)

References 23 publications

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“…Retrospective audit of electronic records of consecutive unselected HIV-positive adult patients admitted to Royal Free London Hospital, between 1 March 2015 and 30 April 2017. Data collected included: patient demographics (age, gender), CD4 cell count, HIV viral load, receipt of ART, admission C-reactive protein (CRP) (elevated: >5 mg/L), platelet, neutrophil, and lymphocyte counts, from which PLR (elevated: >200) 12 and NLR (elevated: >5) 6,12 were derived, need for intensive care unit (ICU) admission, outcome: survival, or death, and final diagnosis. Comparison of those with elevated and normal PLR/NLR admitted to ICU, or who died was done using two-tailed Fisher’s exact test (GraphPad Prism Version 6.0h: GraphPad Software, La Jolla, CA, USA).…”

Section: Methodsmentioning

confidence: 99%

“…[6] Elevated ratios are also associated with Psoriasis and its severity, [7] disease activity in systemic lupus erythematosus, [8] Crohn's disease, [9] sepsis in burns patients, [10] and post-surgical acute kidney injury. [11] In patients with pulmonary tuberculosis elevated NLR is associated with malnutrition and cavitatory disease, indicating increased systemic inflammation [12] and in patients with COPD is associated with dyspnoea, lower FEV1, and poorer survival. [13] In the ageing population elevated NLR is independently associated with all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and significance of elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios among hospitalised HIV-positive adult patients

et al. 2019

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There is increasing interest in the peripheral blood platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation. We audited records of unselected hospitalised HIV-positive adults to identify the frequency of elevated PLR and NLR, potential associations with specific diagnoses, and outcome. Of 259 patients audited, their median age was 47 years (interquartile range = 41–54); 188 (73%) were men. An elevated PLR occurred in 87 patients (33.6%); 67 (25.9%) had an elevated NLR; 200 (77%) had an elevated C-reactive protein (CRP). Elevated PLR and NLR was associated with a variety of infectious, inflammatory, and malignant conditions similar to conditions described in the general non-HIV-infected adult population. Additionally, elevated PLR and NLR occurred both in patients in receipt of antiretroviral therapy (with undetectable viral loads), as well as in those with newly-diagnosed and poorly-controlled infection. Fourteen patients with infectious and inflammatory conditions had an elevated PLR and normal CRP, with/without elevated NLR. There was no association between elevated PLR or NLR and ICU admission, p = 0.1001 and p = 0.605, respectively. Elevated NLR, but not PLR was associated with death, p = 0.0405 and p = 1.000, respectively: two-tailed Fisher’s exact test. The single site nature of the audit and relatively small number of patients limits these observations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and significance of elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios among hospitalised HIV-positive adult patients

et al. 2019

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“…La cavitación pulmonar se caracteriza por la degradación de matriz celular por metalopeptidasas proteolíticas de matriz 9,10 (MMP), encontradas con gran abundancia en los neutrófilos del parénquima pulmonar sugiriendo que la afluencia neutrofílica temprana conduce a un daño tisular que favorece la cavitación 10 . Los pacientes con cavitaciones tienen una carga bacteriana de hasta 10 bacilos 11 , siendo altamente contagiosos 12 . La mayoría de recaídas y fallas del tratamiento provienen de la tuberculosis cavitaria, siendo su diagnóstico crucial para la instauración de una terapia antituberculosa oportuna.…”

Section: Discussionunclassified

“…La mayoría de recaídas y fallas del tratamiento provienen de la tuberculosis cavitaria, siendo su diagnóstico crucial para la instauración de una terapia antituberculosa oportuna. Numerosos estudios han reportado la importancia de factores poblacionales, nutricionales, inmunológicos y otros que, en conjunto, desempeñan un rol protagónico en la morbilidad y mortalidad de pacientes con tuberculosis pulmonar cavitaria [11][12][13][14][15][16] .…”

Section: Discussionunclassified

Tuberculosis pulmonar cavitaria una presentación inusual en pediatría

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Se presenta el caso de una paciente femenina de 5 años quien fue ingresada en el Hospital Nacional Benjamín Bloom, por presentar tos y fiebre persistente de 3 semanas, previo al ingreso en el centro hospitalario, la paciente curso con gastroenteritis aguda por lo que en el Hospital Nacional Zacamil, se sospechó fiebre tifoidea sin embargo al continuar febril y con tos fue transferida al hospital, durante el ingreso hospitalario se realizó el estudio para confirmar enfermedad tuberculosa presentando: prueba mantoux positiva (13 milimetros), radiografía de tórax con cavitación apical izquierda, baciloscopias positivas (16 puntos de los criterios de Stegen y Toledo), también se realizó una tomografía axial torácica computarizada que mostro lesión cavitada a nivel del lóbulo superior izquierdo segmento apical posterior de paredes gruesas tabicadas. Iniciando tratamiento con 4 fármacos antituberculosos (isoniacida, rifampicina, pirazinamida y etambutol), y posterior al egreso hospitalario el paciente continuo con el tratamiento durante 6 meses y presentando evolución clínica satisfactoria.

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“…Bronchial smooth muscles affect airway contraction. Both benign and malignant pulmonary cavities form due to the excretion of necrotic material from necrotic tissues [ 13 – 15 ]. The bronchial wall of the malignant cavity thickens and becomes stiff due to tumor infiltration.…”

Section: Discussionmentioning

confidence: 99%

The value of bronchial and cavity contraction rates in differentiating benign and malignant pulmonary cavities

et al. 2020

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Background: The present study aimed to assess the value of bronchial and cavity contraction percentages in differentiating benign and malignant pulmonary cavities. Methods: Forty-two patients with pulmonary cavities were scanned by dual-phase computed tomography (CT). Then, the cavity and bronchial contraction percentages were respectively measured, the differences between the benign and malignant cavities were compared, and the best diagnostic critical point for differentiating benign and malignant cavities was obtained through the receiver operator characteristic (ROC) curve of the diagnostic test. Results: The contraction percentage of the bronchial end with benign cavities was significantly higher than that of the bronchial end with malignant cavities (P < 0.001). The contraction percentage was significantly higher in the benign group than in the malignant group (P < 0.001). The ROC analysis revealed that the sensitivity and specificity of the bronchial contraction percentage was 90.50 and 86.40%, respectively, while the sensitivity and specificity of the cavity contraction percentage was 90.50 and 90.90%, respectively. Conclusion: The dual-phase CT scanning of the bronchial and cavity contraction percentage can distinguish between benign and malignant cavities.

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Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio

Cited by 27 publications

References 23 publications

Incidence and significance of elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios among hospitalised HIV-positive adult patients

Incidence and significance of elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios among hospitalised HIV-positive adult patients

Tuberculosis pulmonar cavitaria una presentación inusual en pediatría

The value of bronchial and cavity contraction rates in differentiating benign and malignant pulmonary cavities

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