The Platelet Count Can Predict In-hospital Death in HIV-negative Smear-positive Pulmonary Tuberculosis Inpatients

Goto, Hideto; Horita, Nobuyuki; Tashiro, Kunio; Nagai, Kazuyuki; Yamamoto, Masaki; Sato, Takashi; Hara, Yu; Nagakura, Hideyuki; Shibata, Yuji; Watanabe, Hiroki; Nakashima, Kentaro; Ushio, Ryota; Nagashima, Akimichi; Ikeda, Misako; Narita, Atsuya; Sasaki, K.; Kobayashi, Nobuaki; Kudo, Makoto; Kaneko, Takeshi

doi:10.2169/internalmedicine.0138-17

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…In humans, thrombocytopenia is a frequent correlate of many clinically significant infections. Interestingly, low platelet counts have been associated with poor prognosis in tuberculosis patients and reduced survival in sepsis patients , as well as increased risk of fungal infections in liver transplant patients . One study has also suggested the natural history of HIV infection may be influenced by platelet count .…”

Section: Protective Roles For Platelets In Other Infectious Diseases?mentioning

confidence: 99%

Immune role of platelets in malaria

McMorran

2018

ISBT Science Series

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Plasmodium infections causing malaria threaten over 3 billion people from more than ninety countries. Despite control efforts spanning several decades, there are still more than 400,000 fatalities annually. Survival to malaria is largely determined by the host response mounted against the parasite, and the ensuing balance of inflammatory, tissue‐damaging reactions and immune‐mediated mechanisms directed towards controlling pathogen growth. Platelets appear to play important roles in each of these processes. On one hand, platelets have been implicated adversely in cerebral malaria, a severe disease manifestation where microvascular occlusions develop in the brain, leading to inflammatory foci and brain swelling, and causing coma and often death. Platelets adhere to the cerebral endothelium and mediate accumulation of infected erythrocytes in the brain, with the postulated outcome of increasing severity or of even mediating this disease. On the other hand, platelets can directly kill parasites in the periphery by binding to infected red cells and thereby contribute to the host's ability to control the infection. Platelet binding to infected red cells releases an antimicrobial protein, platelet factor 4 (PF4), which accumulates inside the cell and kills the parasite by lysing the food vacuole. The Duffy antigen, a red cell‐expressed receptor of PF4, is required for the PF4 accumulation and parasite killing. Further understanding of the roles of platelets in malaria, especially in clinical disease, is required. This knowledge may provide novel interventions and therapeutic tools, which are so desperately needed.

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Section: Protective Roles For Platelets In Other Infectious Diseases?mentioning

confidence: 99%

Immune role of platelets in malaria

McMorran

2018

ISBT Science Series

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“…Mortality among patients suffering from any infection has been linked to WBC count [ 10 ]. As a result, elevated WBC counts in TB patients may be related to the severity of lung involvement and provide an estimated risk of mortality [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Survival Trend of Tuberculosis Patients and Risk Factors Associated with Mortality and Developing Drug-Resistant Tuberculosis in Hospital Pulau Pinang, Malaysia: A Retrospective Study

Yaghi

Shaheed

Harun

et al. 2022

ARM

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Background: Multidrug resistance TB (MDR-TB) has emerged as a public health issue worldwide, and the mortality rate is worrying. Therefore, this study was conducted to investigate the factors related to MDR-TB occurrence and the survival experience of TB patients. Methods: A retrospective cohort study was conducted at Hospital Pulau Pinang in Malaysia. Medical records of active TB patients from 2014–2018 were reviewed. Cox regression was used to identify the factors associated with MDR-TB development and mortality among TB patients. Results: The patients had a mean age of 48.84 ± 16.713 years, and a majority of the Chinese race (46.4%). Out of 351 TB patients, 325 (92.6%) were drug-susceptible TB, and 26 (7.4%) were diagnosed with MDR-TB. Among drug-susceptible TB patients, 245 (75.4%) achieved successful outcomes, and 73 (22.5%) passed away. In multivariable Cox regression, drug addiction, levels of white blood cells, urea, platelets, and albumin were significantly associated with death. Relapsed TB, alcohol consumption, and being single were significant risk factors for MDR-TB development. Conclusion: Patients achieved a success rate of 75.4%, which is encouraging but still far below the WHO target (at least an 85% success rate) and has room for further improvement.

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“…[ 45 ] Goto et al have reported that reduced platelet count is strongly associated with the death of tuberculosis patients during the treatment. [ 46 ] Therefore, XLT patients with tuberculosis are not only easily misdiagnosed as drug-induced thrombocytopenia but also difficult to treat. Irrational use of antituberculosis drugs may aggravate thrombocytopenia and further increase the risk of death.…”

Section: Discussionmentioning

confidence: 99%

Clinical and genetic analysis of 2 rare cases of Wiskott–Aldrich syndrome from Chinese minorities

Liu

Wang²,

Li³

et al. 2021

Medicine

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Rationale: Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by thrombocytopenia, small platelets, eczema, immunodeficiency, and an increased risk of autoimmunity and malignancies. X-linked thrombocytopenia (XLT), the milder phenotype of WAS, is always limited to thrombocytopenia with absent or slight infections and eczema. Here, we illustrated the clinical and molecular characteristics of 2 unrelated patients with WAS from Chinese minorities. Patient concerns: Patient 1, a 13-day-old male newborn of the Chinese Lahu minority, showed a classic WAS phenotype, including thrombocytopenia, small platelets, buttock eczema, and recurrent infections. Patient 2, an 8-year-and 8-month-old boy of the Chinese Zhuang minority, presented an XLT phenotype without eczema and repeated infections. Diagnosis: Next-generation sequencing was performed to investigate the genetic variations. Flow cytometry was used to quantify the expression of WAS protein and analyze the lymphocyte subsets. A novel frameshift WAS mutation (c.927delC, p.Q310Rfs∗135) and a known nonsense WAS mutation (c.1090C>T, p.R364X) were identified in Patient 1 and Patient 2, respectively. Both patients were confirmed to have WAS protein deficiency, which was more severe in Patient 1. Meanwhile, the analysis of lymphocyte subsets revealed an abnormality in Patient 1, but not in Patient 2. Combined with the above clinical data and genetic characteristics, Patient 1 and Patient 2 were diagnosed as classic WAS and XLT, respectively. In addition, many miliary nodules were accidentally found in abdominal cavity of Patient 2 during appendectomy. Subsequently, Patient 2 was confirmed with pulmonary and abdominal tuberculosis through further laboratory and imaging examinations. To our knowledge, there have been only a few reports about WAS/XLT with tuberculosis. Interventions: Both patients received anti-infection therapy, platelet transfusions, and intravenous immunoglobulins. Moreover, Patient 2 also received antituberculosis treatment with ethambutol and amoxicillin-clavulanate. Outcomes: The clinical symptoms and hematological parameters of these 2 patients were significantly improved. Regrettably, both patients discontinued the treatment for financial reasons. Lessons: Our report expands the pathogenic mutation spectrum of WAS gene and emphasizes the importance of molecular genetic testing in diagnosing WAS. Furthermore, researching and reporting rare cases of WAS from different populations will facilitate diagnosis and treatment of this disease.

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The Platelet Count Can Predict In-hospital Death in HIV-negative Smear-positive Pulmonary Tuberculosis Inpatients

Cited by 9 publications

References 14 publications

Immune role of platelets in malaria

Immune role of platelets in malaria

Survival Trend of Tuberculosis Patients and Risk Factors Associated with Mortality and Developing Drug-Resistant Tuberculosis in Hospital Pulau Pinang, Malaysia: A Retrospective Study

Clinical and genetic analysis of 2 rare cases of Wiskott–Aldrich syndrome from Chinese minorities

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