• Sonti Sulochana Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.
  • Subhashini V Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.
  • Chitra Srinivasan Department of Pathology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.


 Objective: This study was a prospective analysis of hematological changes in pulmonary tuberculosis (TB). The objectives of this study are (1) to study the changes in different parameters of hemogram in association of sputum-positive pulmonary TB, (2) to evaluate the disease severity and patient infectivity, (3) to determine the most common type and severity of anemia in pulmonary TB patients, and (4) to count platelets in pulmonary TB patients. TB is an important communicable disease in the world and is a major public health problem in India. Hematogical abnormalities associated with TB have been completely investigated in the literature though it is a common condition in India.

Methods: A total of 150 patients of acid-fast bacilli-positive cases were included, and disseminated TB, childhood TB, and patients receiving anti-TB drugs were excluded from this study.

Results: Among the 150 patients, anemia was observed in 116 cases, normocytic normchromic and microcytic hypochromic picture, leukocytosis in 68 patients, thrombocytosis in 50 patients, thrombocytopenia in 5 patients, and ESR levels were elevated in more than 82% of patients.

Conclusion: A complete hemogram has been demonstrated in patients with acid-fast bacilli-positive cases in the present study. Since there was a paucity of literature in the hematological changes associated with TB, this study aimed at reinforcing the fact that they can be valuable tools in monitoring pulmonary TB.

Keywords: Tuberculosis, AFB stain, Anemia, Leukocytosis, Thrombocytosis, ESR.


1. Sauders E. Robbins Basic pathology. 8th ed. London: Cambridge Press; 2007. p. 516-20.
2. Park K. Park’s Text Book of Preventive and Social Medicine. 23rd ed. Jabalpur: Banarsidas Bhanot; 2015. p. 176-83.
3. WHO. Weekly Epidemiological Record. 23rd ed. Geneva: WHO; 2004.
p. 4.
4. Olive VM, Cezario GA, Cacto RA. Pulmonary tuberculosis: Hematology, serum biochemistry and relationship with the disease condition. J Venom Anim Toxins Incl Trop Dis 2008;14:71-8.
5. Youmans GP, Paterswon PY, Sommers HM. The Biological and Clinical Basis of Infectitious Diseases. 2nd ed. Philadelphia: W. B. Saunders; 1980.
6. Shaji J, Sheikh M. Drug resistance tuberculosis: Recent approach in polymer based nanomedicine. Int J Pharm Pharm Sci 2017;8:1-6.
7. Iseman MD, Bentz RR, Fraser RI, Locks MO, Ostrow JH, Sewell EM. Guidelines for the investigation and management of tuberculosis contacts. American Thoracic Society. Ann Rev Res Dis 1976;114:459.
8. Comstock GW. Tuberculosis in twins: A re-analysis of the prophit survey. Am Rev Respir Dis 1978;117:621-4.
9. Govt. Of India. TB India, RNTCP Status Report, Central TB Division. New Delhi: Ministry of Health and Family Welfare; 2008.
10. Southwick L. Testing Tuberculosis. 4th ed. Philadelphia, PA: Australian Publishing; 2007. p. 1218.
11. Govt. Of India. TB India RNTCP Status Report, Central TB Division. New Delhi: Ministry of Health and Family Welfare; 2010.
12. Govt. Of India. Guidlines On programmatic Management of Drug Resistant TB in India. New Delhi: Ministry of Health and Family Welfare; 2012.
13. WHO. TB/HIV, A Clinical Manual. 2nd ed. Geneva: World Health Organization; 2004.
14. WHO. Policy Frame Work for Implementing New Tuberculosis Diagnostics. Geneva: World Health Organization; 2010.
15. Machado Russo De Moura AC, Court Gonzalez Mosegui GB, Manso De Mello Vianna CI, Cordeiro BC. Cost effectiveness analysis of directly observed therapy for tuberculosis and its expansion in Rio de Janeiro CIty. Int J Pharm Pharm Sci 2017;9:171-5.
16. Global Tuberculosis Control WHO. Geneva. Available from: http://www.who.int/tb/publications/global report, 2015.
17. Vijayan V, Sagal Das K, editors. Pulmonary Tuberculosis h Suredrasharma Tuberculosis. 1st ed. New Delhi: Jaypee Publisher; 2009. p. 217-27.
18. Philip CH. USA Tuberculosis and othe mycobacterial disease. In: Murray and Nadels Text Book of Respiratory Medicine. 4th ed. Philadelphia, PA: Elsevier; 2005. p. 979-97.
19. Zaman K. Tuberculosis: A global health problem. J Health Popul Nutr 2010;1:111-3.
20. Al-Omar IA, Ashban RM, Shah AH. Hematological abnormalities in Saudis suffering from pulmonary tuberculosis and their response to the treatment. Res J Pharmacol 2009;3:78-85.
21. Yaranal PJ, Umashankar T, Harish SG. Hematological profile in pulmonary tuberculosis. Int J Health Rehabil Sci 2013;2:50-5.
22. Singh KJ, Ahulwalia G, Sharma SK, Saxena R, Chaudary VP, Anant M. Significance of haematological manifestations in patients with tuberculosis. J Asso Physicians Ind 2001;49:788-94.
23. Robert T, Mean JR. The anaemia of chronic disorder. Wintrobes Haematol 2005;106:3268-70.
24. Weiss G, Bogdan C, Hentz MW. Pathways for regulation of macrophage Iron metabolism by the anti-inflammatory cytokines IL-4 and IL-13. J Immunol 1997;158:420-5.
25. Olaniyi JA, Aken’Ova YA. Haematological profile of patients with pulmonary tuberculosis in Ibadan, Nigeria. Afr J Med Sci 2003;32:239-42.
26. Tanzeela T, Bshir MB, Yaqoob M. Comparative efficacy of different laboratory technique used in diagnosis of tuberculosis in human population. J Med Sci 2001;2:137-44.
27. Maartens G, Willcox PA, Benatar SR. Millary tuberculosis: Rapid diagnosis, hematologic abnormalities and outcome in 109 treated adults. Am J Med 1990;89:291-6.
28. Baynes RD, Flax H, Bothwell TH, McDonald TP, Atkinson TP, Chetty N, et al. Reactive thrombocytosis in pulmonary tuberculosis. J Clin Pathol 1987;40:676-9.
29. Kartloglu Z, Cerrahoglu K, Okutan O, Ozturk A, Aydilek R. Parameters of blood coagulation in patients with pulmonary tuberculosis. Internet J Intern Med 2001;2: 2.
30. Goldenberg AS. Haematological abnormalities and mycobacterial infection. In: Williams NR, Stuart GM, editors. Tuberculosis. Boston: Little-Brown Company; 1996. p. 645-7.
31. Bala J, Bagdi R, Bedi S, Kumar A. Tuberculosis as a cause of change in haematological parameters in tertiary Care Hospital. Natl J Integr Res Med 2015;6:31-5.
166 Views | 347 Downloads
How to Cite
Sulochana, S., S. V, and C. Srinivasan. “PULMONARY TUBERCULOSIS - A PROSPECTIVE ANALYSIS OF HEMATOLOGICAL CHANGES”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 4, Apr. 2018, pp. 169-72, doi:10.22159/ajpcr.2018.v11i4.23177.
Original Article(s)