Tuberculosis and Venous Thromboembolism: a case series

Gonçalves, Irlen Antônio; Alves, Daniela Costa; Carvalho, Aurora; Brito, Marcelo; Calvário, Fernando; Duarte, Raquel

doi:10.1186/1757-1626-2-9333

Cited by 37 publications

(35 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Association of PTB with PTE is concordant with literature reports [24] and is thought to be due to increased plasma fibrinogen and factor III, reactive thrombocytosis, stasis from lymph node compression or endothelial dysfunction [25]. The high proportion of patients is probably related with the high prevalence of PTB in Kenya [26].…”

Section: Comorbiditiessupporting

confidence: 87%

Pulmonary thromboembolism in an East African tertiary referral hospital

Ogeng’o

Obimbo

Olabu

et al. 2011

J Thromb Thrombolysis

View full text Add to dashboard Cite

Pulmonary thromboembolism (PTE) is a frequent cause of mortality in Kenya, but its characteristics are hardly reported in Subsaharan Africa. To describe the pattern of PTE among black Africans, in a Kenyan referral hospital. Retrospective study at Kenyatta National Hospital (KNH), Nairobi, Kenya. Records of patients seen between January 2005 and December 2009 were examined for mode of diagnosis, comorbidities, age, gender, treatment and outcome. Data were analyzed using SPSS version 15.0 and are presented in tables and bar charts. One hundred and twenty-eight (60 male; 68 female) cases were analyzed. Diagnosis was made by clinical evaluation, a Well's score of >4.0, high D-dimer levels and ultrasound demonstration of a proximal deep venous thrombosis (DVT, 35.9%), lung spiral computer tomography (CT, 50%), multidetector CT (7.8%) and angiography (6.3%). Most frequent comorbidities included DVT (36%); hypertension (18.8%); pulmonary tuberculosis (PTB, 12.5%); HIV infection (10.9%), pueperium, diabetes mellitus and cigarette smoking (9.4% each). Mean age was 40.8 years (range 5-86 years) with a peak between 30 and 50 years. Over 46% of patients were aged 40 years and less. Male:female ratio was 1:1.13. All the patients were treated with anticoagulants and thrombolytics with only one having embolectomy. Ninety-two patients (71.9%) recovered, 18.8% of them with cor pulmonale, while 28.1% died. PTE is not uncommon in Kenya. It affects many individuals below 40 years without a gender bias, and carries high morbidity and mortality. Associated comorbidities include venous thrombosis, lifestyle conditions and communicable diseases. Control measures targeting both are recommended.

show abstract

Section: Comorbiditiessupporting

confidence: 87%

Pulmonary thromboembolism in an East African tertiary referral hospital

Ogeng’o

Obimbo

Olabu

et al. 2011

J Thromb Thrombolysis

View full text Add to dashboard Cite

show abstract

“…The association between inflammation, haemostatic changes and hypercoagulable state has been established in tuberculosis recently. Another mechanism of DVT is retroperitoneal adenopathies in patient s with tuberculosis causing compression of the inferior vena cava in the absence of any haemostatic abnormalities [6]. This is unlikely in our patient as we have excluded abdominal adenopathies by ultrasonographically.…”

Section: Discussionmentioning

confidence: 92%

A rare complication of pulmonary tuberculosis: a case report

Kumarihamy¹,

Ralapanawa

Jayalath

2015

BMC Res Notes

View full text Add to dashboard Cite

BackgroundPulmonary tuberculosis remains an important public health problem globally and one of the most prevalent infectious diseases in Sri Lanka. It can cause a wide variety of complications but hematological manifestations are rare. According to our literature survey, this is the first reported case of the disease associated with deep vein thrombosis in Sri Lanka.Case presentationA 37 year old Sri Lankan Sinhalese female presented with fever of one month’s duration with productive cough and two weeks painless left lower limb swelling. Chest X-ray showed bilateral inflammatory shadows with a cavitatory lesion on the right apical region. A computed tomographic pulmonary angiography scan excluded pulmonary embolism. She had rising mycoplasma antibody titre (four fold). Acute deep vein thrombosis of the left lower limb was confirmed by venous duplex. Pulmonary tuberculosis was confirmed with positive culture for Mycobacterium tuberculosis. She was treated with clarythromycin, enoxaparin, warfarin and anti tuberculus drugs. It was difficult to maintain her International Normalizing Ratio in the therapeutic range due to drug interactions and poor compliance. At five months of presentation she died of massive pulmonary embolism.ConclusionOur case emphasizes that patients with severe pulmonary tuberculosis are at risk of developing thromboembolism and superadded infections. It should be noted that even though starting anti tuberculosis drugs improved haemostatic disturbances, achieving the target International Normalizing Ratio was difficult due to drug interactions. Therefore these patients should be closely followed up to prevent complications and death from pulmonary embolism.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-0990-6) contains supplementary material, which is available to authorized users.

show abstract

“…The association with staphylococcal infections and septicemia in children has been reported previously [20]. In subSaharan Africa, the inflammation induced by tuberculosis and a hypercoaguable state has been described [21] and is probably a result of the possibly transitory decrease of anticoagulant (protein S) and increase of the procoagulant (factor VIII) activity [22]. Similarly, HIV is known to carry a significant risk [23].…”

Section: Discussionmentioning

confidence: 92%