Clinical Characteristics of Coexisting Pulmonary Thromboembolism in Patients With Respiratory Tuberculosis

Am J Med Sci. 2017 Feb;353(2):166-171. doi: 10.1016/j.amjms.2016.11.025. Epub 2016 Nov 18.

Abstract

Objectives: Data regarding coexisting pulmonary thromboembolism (PTE) in patients with tuberculosis are limited. The aim of this study was to investigate the clinical features of coexisting PTE in patients with respiratory tuberculosis.

Methods: Clinical parameters were retrospectively compared between the tuberculosis group (PTE and coexisting respiratory tuberculosis) and unprovoked or provoked group selected from a single institution in South Korea, a country that has an intermediate tuberculosis burden.

Results: Twenty-four patients with PTE and concomitant respiratory tuberculosis were identified. These patients accounted for 1.0% of 2,386 patients with respiratory tuberculosis and 2.8% of 867 PTE patients who were enrolled over the same period. Compared with the unprovoked group, the tuberculosis group had significantly lower body mass index, higher levels of blood inflammatory markers and higher pulmonary embolism severity index (PESI) with a higher incidence of high PESI class (≥3). The tuberculosis group had a significantly lower incidence of central PTE than the unprovoked group, but the rate of right ventricular dilation on computed tomography scan was not significantly different between the 2 groups. Adverse outcomes, PTE-related in-hospital mortality and the recurrence of venous thromboembolism were not significantly different between the tuberculosis and unprovoked or provoked group.

Conclusions: The coexistence of PTE and respiratory tuberculosis rarely occurred in clinical practice. Compared with unprovoked PTE, PTE with respiratory tuberculosis is characterized by lower body mass index, higher levels of blood inflammatory markers, higher PESI and less frequent central PTE, but it is not associated with any differences in outcomes caused by PTE.

Keywords: Computed tomography; Pulmonary embolism; Treatment outcome; Tuberculosis.

MeSH terms

  • Aged
  • Antitubercular Agents / pharmacology
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Comorbidity
  • Drug Resistance, Bacterial
  • Drug Resistance, Multiple
  • Female
  • Humans
  • Isoniazid / pharmacology
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / epidemiology*
  • Pulmonary Embolism / microbiology
  • Republic of Korea / epidemiology
  • Tomography, X-Ray Computed
  • Tuberculosis, Pulmonary / blood
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antitubercular Agents
  • C-Reactive Protein
  • Isoniazid