The effect of diabetes control status on treatment response in pulmonary tuberculosis: a prospective study

Khayyam

Tropical Med Int Health

et al. 2017

Section: Discussioncontrasting

confidence: 75%

Diabetes prevalence and its impact on health‐related quality of life in tuberculosis patients

Khayyam

Tropical Med Int Health

et al. 2017

“…In previous reports, the presence of cavities was associated with HbA1C level, and cavity formation was significantly more common in uncontrolled DM patients than in non-DM patients [19,31]. Also, whereas a previous study showed no significant difference in the formation of cavities between non-DM and well-controlled DM in TB patients [19], there has yet to be any corresponding reports on NTM. In our study, there was no significant difference in the status of diabetes control among DM patients in NTM and TB patients.…”

Section: Discussionmentioning

confidence: 95%

“…Age, gender, body mass index (BMI), smoking history, previous TB history, underlying disease (DM, the status of diabetes control, malignancy, and chronic obstructive pulmonary disease [COPD]), initial symptoms (cough, sputum, hemoptysis, dyspnea, or fever), and laboratory findings (albumin, white blood cell [WBC], C-reactive protein [CRP]) of all the study patients were recorded. Uncontrolled DM was defined as glycated hemoglobin (HbA1C) level ≤ 7.0% [19]. NTM pathogens proven in culture were also recorded.…”

Section: Methodsmentioning

confidence: 99%

Comparison of chest CT findings in nontuberculous mycobacterial diseases vs. Mycobacterium tuberculosis lung disease in HIV-negative patients with cavities

Kim

Park

et al. 2017

PLoS ONE

ObjectivesThis article focuses on the differences between CT findings of HIV-negative patients who have cavities with nontuberculous mycobacteria (NTM) disease and those with Mycobacterium tuberculosis infections (TB).MethodsWe retrospectively reviewed 128 NTM disease patients (79 males and 49 females) with cavities in chest CT, matched for age and gender with 128 TB patients in the same period. Sputum cultures of all patients were positive for pathogens. Two independent chest radiologists evaluated the characteristics of the largest cavity and related factors.ResultsInterobserver agreement was excellent (κ value, 0.853–0.938). Cavity walls in NTM disease were significantly thinner (6.9±4 mm vs 10.9±6 mm, P<0.001) and more even (the ratio of thickness, 2.6±1 vs 3.7±2, P<0.001) than those in TB. The thickening of adjacent pleura next to the cavity was also significantly thicker in NTM than TB (P<0.001). However, in the multivariate analysis, thickening of adjacent pleura was the only significant factor among the representative cavity findings (Odds ratio [OR], 6.49; P<0.001). In addition, ill-defined tree-in-bud nodules (OR, 8.82; P<0.001), number of non-cavitary nodules (≥10mm) (OR, 0.72; P = 0.003), and bronchiectasis in the RUL (OR, 5.3; P = 0.002) were significantly associated ancillary findings with NTM disease in the multivariate analysis.ConclusionsThe major cavities in NTM disease generally have thinner and more even walls than those in TB. When cavities are associated with adjacent pleural thickening, ill-defined satellite tree-in-bud nodules, or fewer non-cavitary nodules ≥10 mm, these CT findings are highly suggestive of NTM disease rather than TB.

“…Diabetes mellitus (DM) is an important co-morbidity in patients with tuberculosis (TB) because it can increase the risk of active TB [3, 4], have severe clinical manifestations, and cause worse outcomes [5, 6]. DM can also cause dysregulation of the immune system, resulting in altered levels of cytokines and chemokines [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Shin

Kim

et al. 2017

PLoS ONE

BackgroundThe sensitivity of interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection could be affected by conditions of immune dysregulation. For this reason, diabetes mellitus (DM) may increase the frequency of indeterminate results of IGRAs. However, there have been inconsistent reports of role of DM on indeterminate IGRA results.MethodsWe retrospectively reviewed all patients who underwent QuantiFERON-TB Gold In-Tube testing (QFT-GIT) at Chonnam National University Hospital. We collected the clinical and laboratory data of these patients.ResultsOf all 3,391 subjects, 1,265 (37.3%) had a positive QFT-GIT result, 266 (7.8%) had an indeterminate result, and 1,860 (54.9%) had a negative result. The mean age was 54.8 ± 18.1 years and 55.0% of the patients were male. There were 512 (15.1%) patients with DM. Multivariable analysis revealed that systemic corticosteroid use, tuberculosis, lymphocytopenia, low serum albumin, and high serum C-reactive protein (CRP) levels were significantly associated with indeterminate QFT-GIT results. However, DM was not associated with indeterminate QFT-GIT results (adjusted odds ratio, 0.98; 95% confidence interval, 0.69–1.41; P = 0.939). After propensity score matching, DM was not associated with indeterminate results of QFT-GIT.ConclusionIn this large cohort study, DM does not affect the incidence of indeterminate results of QFT-GIT.