Vishal Sharma1, Harshal S Mandavdhare2, Sandeep Lamoria3, Harjeet Singh4, Amit Kumar2. 1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: docvishalsharma@gmail.com. 2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. 3. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Delhi 110001, India. 4. Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Abstract
BACKGROUND: Response to treatment is often used as a criterion for the diagnosis of abdominal tuberculosis. AIM: To determine utility of serum C reactive protein (CRP) in assessment of response to anti-tubercular therapy (ATT) in abdominal tuberculosis (ATB). METHODS: We retrospectively analysed the database of patients with suspected ATB (intestinal and/or peritoneal). Response to ATT was assessed using subjective and objective (ulcer healing or ascites resolution) parameters. Serum CRP levels were estimated at baseline and then at 2 months and 6 months of ATT. RESULTS: One hundred and twelve patients were included in the analysis. The mean age was 36.57 ± 15.04 years and 54.46% (61/112) were males. Sixty-six patients (58.92%) had intestinal, 28 (25%) had peritoneal and 18 (16.07%) had both. Eleven patients had a normal CRP at baseline while 101 had elevated levels. The CRP levels declined in 94 patients at 6 months. One patient with increased levels at 2 months had multi-drug resistant TB. Seven patients showed elevated or plateaued CRP levels on follow-up. These patients had underlying Crohn's disease (3 patients), peritoneal carcinomatosis (1), inter-current infection (1), lymphoma (1) and non-healing ulcers (1). CONCLUSION: Lack of decline in CRP may suggest alternative diagnosis or drug-resistant tuberculosis.
BACKGROUND: Response to treatment is often used as a criterion for the diagnosis of abdominal tuberculosis. AIM: To determine utility of serum C reactive protein (CRP) in assessment of response to anti-tubercular therapy (ATT) in abdominal tuberculosis (ATB). METHODS: We retrospectively analysed the database of patients with suspected ATB (intestinal and/or peritoneal). Response to ATT was assessed using subjective and objective (ulcer healing or ascites resolution) parameters. Serum CRP levels were estimated at baseline and then at 2 months and 6 months of ATT. RESULTS: One hundred and twelve patients were included in the analysis. The mean age was 36.57 ± 15.04 years and 54.46% (61/112) were males. Sixty-six patients (58.92%) had intestinal, 28 (25%) had peritoneal and 18 (16.07%) had both. Eleven patients had a normal CRP at baseline while 101 had elevated levels. The CRP levels declined in 94 patients at 6 months. One patient with increased levels at 2 months had multi-drug resistant TB. Seven patients showed elevated or plateaued CRP levels on follow-up. These patients had underlying Crohn's disease (3 patients), peritoneal carcinomatosis (1), inter-current infection (1), lymphoma (1) and non-healing ulcers (1). CONCLUSION: Lack of decline in CRP may suggest alternative diagnosis or drug-resistant tuberculosis.
Authors: Joseph Kattan; Fady Gh Haddad; Lina Menassa-Moussa; Carole Kesrouani; Stephanie Daccache; Fady G Haddad; David Atallah Journal: Case Rep Oncol Med Date: 2019-11-04