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Timestamp: 2019-04-23 00:43:26+00:00

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Tuberculosis (TB) affects the production and life span of all hematologic cellular components. This chapter reviews and updates known hematologic effects of TB and its therapy. Myelophthisic anemias are characterized by the presence of teardrop erythrocytes, nucleated erythrocytes, and early granulocytes, which can be seen on the peripheral blood smear. In miliary TB, the bone marrow may become directly infiltrated with tuberculosis. Neutrophils, basophils, eosinophils, and the monocyte/macrophage line are all subtypes of granulocytes and all are commonly affected during the course of TB and its treatment. Lymphocytopenia and lymphocytosis have both been reported for active TB. While lymphocytopenia may be associated with marrow dysfunction, haptoglobin has recently been reported to suppress T-cell proliferation. Haptoglobin is an acute-phase protein which primarily scavenges hemoglobin and exhibits strong inhibition of T-cytokine release. Lymphocytopenia and lymphocytosis have both been reported for active TB. Lymphocyte proliferation occurs in the blood, secondary lymphoid tissues, and organs affected by TB. Diverse coagulation abnormalities have been reported in the setting of TB. Acquired factor V dysfunction due to the presence of an immunoglobulin inhibitor has been reported to cause hemorrhage. Despite the fact that nearly all of the antituberculous antimicrobials may produce hematologic side effects, routine hematologic monitoring is recommended by the manufacturer for only three commonly used anti-TB antibiotics—cycloserine, ethambutol, and rifabutin—and the strength of the recommendation varies from drug to drug.
1. Adamson, J. W.,, and A. J. Ersley. 1990. Aplastic anemia, p. 158–174. In W. J. Williams,, E. Beutler,, A. J. Ersley, et al. (ed.), Hematology, 4th ed. McGraw-Hill, New York, NY.
2. Aliaga, J. L.,, J. de Gracia,, R. Vidal,, M. Pico,, P. Flores,, and G. Sampol. 1990. Acquired factor V deficiency in a patient with pulmonary tuberculosis. Eur. Respir. J. 3: 109– 110.
3. Al-Majed, S. A.,, A. K. Al-Momen,, F. A. Al-Kassimi,, A. Al-Zeer,, A. M. Kambal,, and H. Baaqil. 1995. Tuberculosis presenting as immune thrombocytopenic purpura. Acta Haematol. 94: 135– 138.
4. Andre, J.,, R. Schwartz,, and W. Dameshek. 1961. Tuberculosis and myelosclerosis with myeloid metaplasia; report of three cases. JAMA 178: 1169– 1174.
5. Appleberg, R.,, and M. T. Silva. 1989. T-cell-dependent chronic neutrophilia during mycobacterial infections. Clin. Exp. Immunol. 78: 478– 483.
6. Aquinas, M.,, W. G. Allan,, P. A. Horsfall,, P. K. Jenkins,, W. Hung-Yan,, D. Girling,, R. Tall,, and W. Fox. 1972. Adverse reactions to daily and intermittent rifampicin regimens for pulmonary tuberculosis in Hong Kong. Br. Med. J. 1 (803): 765– 771.
7. Balsarkar, D.,, and M. Joshi. 2009. Ileal tuberculosis presenting as a case of massive rectal bleeding. Case report. BHJ 51: 72– 74.
8. Barry, S.,, R. Breen,, M. Lipman,, M. Johnson,, and G. Janossy. 2009. Impaired antigen-specific CD4 + T lymphocyte responses in cavitary tuberculosis. Tuberculosis 89: 48– 53.
9. Boeser, H. P. 1974. Iron metabolism in inflammation and malignant disease, p. 605–640. In A. Jacobs and, M. Worwood (ed.), Iron in Biochemistry and Medicine, II. Academic Press, London, England.
10. Boots, R. J.,, A. W. Roberts,, and D. McEvoy. 1992. Immune thrombocytopenia complicating pulmonary tuberculosis: case report and investigation of mechanisms. Thorax 47: 396– 397.
11. Brastianos, P.,, J. Swanson,, M. Torbenson,, J. Sperati,, and P. C. Karakousis. 2006. Tuberculosis-associated haemophagocytic syndrome. Lancet Infect. Dis. 6: 447– 454.
12. Cameron, S. J. 1974. Tuberculosis and the blood—a special relationship? Tubercle 55: 55– 72.
13. Casanova-Roman, M. M.,, J. Rios,, A. Sanchez-Porto, et al. 2004. Deep venous thrombosis associated with pulmonary tuberculosis and transient protein S deficiency. Am. J. Hematol. 7: 118– 119.
14. Chandra, P.,, S. A. Chaudhery,, F. Rosner,, and M. Kagen. 1975. Transient histiocytosis with striking phagocytosis of platelets, leukocytes, and erythrocytes. Arch. Intern. Med. 135: 989– 991.
16. Chia, Y. C.,, and S. J. Machin. 1979. Tuberculosis and severe thrombocytopaenia. Br. J. Clin. Pract. 33: 55– 56, 58.
17. Cicchitto, G.,, M. Parravicini,, S. De Lorenzo, et al. 1999. Tuberculosis and Pelger-Huet anomaly. Case report. Panminerva Med. 41: 367– 369.
18. Clairborne, R. A.,, and A. K. Dutt. 1985. Isoniazid-induced pure red cell aplasia. Am. Rev. Respir. Dis. 131: 947– 949.
19. Das, B. S.,, U. Devi,, C. Mohan Rao,, V. K. Srivastava,, and P. K. Rath. 2003. Effect of iron supplementation on mild to moderate anaemia in pulmonary tuberculosis. Br. J. Nutr. 90: 541– 550.
20. Deveci, F.,, H. H. Akbulut,, I. Celik,, M. H. Muz,, and F. Ilhan. 2006. Lymphocyte subpopulations in pulmonary tuberculosis patients. Mediators Inflamm. 6: 1– 6.
21. Douglas, S. W.,, and J. W. Adamson. 1990. The anemia of chronic disorders: studies of marrow regulation and iron metabolism. Blood 45: 55– 65.
22. Ebrahim, O.,, P. I. Folb,, S. C. Robson,, and P. Jacobs. 1995. Blunted erythropoietin response to anaemia in tuberculosis. Eur. J. Haematol. 55: 251– 254.
23. Ersley, A. J. 1990. Hypersplenism and hyposplenism, p. 695. In W. J. Williams,, E. Beutler,, A. J. Ersley, et al. (ed.), Hematology, 4th ed. McGraw-Hill, New York, NY.
24. Eum, S. Y.,, J. H. Kong,, M. S. Hong,, Y. J. Lee,, J. H. Kim,, S. H. Hwang,, S. N. Cho,, L. Via,, and C. Barry III. 2010. Neutrophils are the predominant infected phagocytic cells in the airways of patients with active pulmonary TB. Chest 137: 122– 128.
25. Fahal, I. H.,, P. S. Williams,, R. E. Clark,, and G. M. Bell. 1992. Thrombotic thrombocytopenic purpura due to rifampicin. BMJ 304: 882.
26. Fantin, B.,, V. Joly,, C. Elbim, et al. 1996. Lymphocyte subset counts during the course of community-acquired pneumonia: evolution according to age, human immunodeficiency virus status, and etiologic microorganisms. Clin. Infect. Dis. 22: 1096– 1098.
27. Finch, S. C.,, and B. Castleman. 1963. Case records of the Massachusetts General Hospital. N. Engl. J. Med. 238: 378.
28. Gallagher, N. I.,, and R. M. Donati. 1968. Inappropriate erythropoietin elaboration. Ann. N. Y. Acad. Sci. 149: 528– 538.
29. González-Cortés, C.,, D. Reyes-Ruvalcaba,, C. Diez-Tascón,, and O. Rivero-Lezcano. 2009. Apoptosis and oxidative burst in neutrophils infected with Mycobacterium spp. Immunol. Lett. 126: 16– 21.
30. Gupta, R.,, M. Bruteon,, J. Fell,, and H. Lyall. 2003. An Afghan child with deep vein thrombosis. J. R. Soc. Med. 96: 289– 291.
31. Huxley, H. M.,, and H. M. Knox-Macaulay. 1992. Tuberculosis and the haemopoietic system. Baillier’s Clin. Haematol. 5: 101– 129.
32. Juhlin, L. 1963. Basophil and eosinophil leukocytes in various internal disorders. Acta Med. Scand. 174: 249– 254.
33. Jurak, S. S.,, R. Aster,, and H. Sawaf. 1983. Immune thrombocytopenia associated with tuberculosis. Clin. Pediatr. 22: 318– 319.
34. Kaufmann, S. H. 1991. The macrophage in tuberculosis: sinner or saint? The T-cell decides. Pathobiology 59: 153– 155.
35. Kelsey, P. R. 1990. Blood film and marrow, p. 3. In I. W. Delamore and, J. A. Liu Yin (ed.), Haematologic Aspects of Systemic Disease. Bailliere Tindal, London, England.
36. Khvitiya, N.,, G. Khechinashvili,, and S. Sabanadze. 2004. Erythrocyte structure and function in fibrocaverno. Bull. Exp. Biol. Med. 138: 613– 615.
37. Kuo, P. H.,, P. C. Yang,, S. S. Kuo,, and K. T. Luh. 2001. Severe immune hemolytic anemia in disseminated tuberculosis with response to antituberculosis therapy. Chest 119: 1961– 1963.
38. Kyle, R. A. 1982. Monoclonal gammopathy of undetermined significance (MGUS): a review. Clin. Haematol. 1: 123– 150.
39. Laszlo, J.,, and A. T. Huang. 1990. Anemia associated with marrow infiltration, p. 546–548. In W. J. Williams,, E. Beutler,, A. J. Ersley, et al. (ed.), Hematology, 4th ed. McGraw-Hill, New York, NY.
40. Laurence, J. 1993. T-cell subsets in health, infectious disease, and idiopathic CD4+ T-lymphocytopenia. Ann. Intern. Med. 119: 55– 62.
41. Law, K.,, M. Weiden,, T. Harkin,, T. Tchou-Wong,, C. Chi,, and W. N. Rom. 1996. Increased release of interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha by bronchoalveolar cells lavaged from involved sites in pulmonary tuberculosis. Am. J. Respir. Crit. Care Med. 153: 799– 804.
42. Lee, C. H.,, and C. J. Lee. 1989. Thrombocytopenia—a rare but potentially serious side effect of initial daily and interrupted use of rifampicin. Chest 96: 202– 203.
43. Marchasin, S.,, R. O. Wallerstein,, and P. M. Aggeler. 1964. Variations of the platelet count in disease. Calif. Med. 101: 95– 100.
44. Mariani, F.,, D. Goletti,, A. Ciaramella,, A. Martino,, V. Colizzi,, and M. Fraziano. 2001. Macrophage response to Mycobacterium tuberculosis during HIV infection: relationships between macrophage activation and apoptosis. Curr. Mol. Med. 1: 209– 216.
45. Mengistu, Z.,, V. Engh,, K. K. Melby,, E. von der Lippe,, and E. Qvigstad. 2007. Postmenopausal vaginal bleeding caused by endometrial tuberculosis. Acta Obstet. Gynecol. Scand. 86: 631– 632.
46. Murray, H. W. 1978. Transient autoimmune hemolyctic anemia and pulmonary tuberculosis. N. Engl. J. Med. 299: 488.
47. Murray, H. W.,, C. U. Tuazon,, N. Kirmani,, and J. N. Sheagren. 1978. The adult respiratory distress syndrome associated with miliary tuberculosis. Chest 73: 536– 539.
48. Naithani, R.,, N. Agrawal,, and V. Choudhary. 2007. Deep venous thrombosis associated with tuberculosis. Blood Coagulation Fibrinolysis 18: 377– 380.
49. Nusbaum, N. J. 1990. Concise review: genetic bases for sideroblastic anemia. Am. J. Hematol. 37: 41– 44.
50. O’Connor, N. J.,, and A. V. Hotfbrand. 1998. Anaemia in systemic disease, p. 38. In I. W. Delamore and, J. A. Liu Yin (ed.), Haematologic Aspects of Systemic Disease. Bailliere Tindall, London, England.
51. Ogata, H.,, S. Sakai,, F. Koiwa,, H. Tayama,, E. Kinugasa,, T. Ideura,, and T. Akizawa. 1999. Plasma exchange for acquired hemophilia: a case report. Ther. Apher. 3: 320– 322.
52. Olaniyi, J. A.,, and Y. A. Aken’Ova. 2003. Haemotologic profile of patients with pulmonary tuberculosis in Ibadan, Nigeria. Afr. J. Med. Sci. 32: 239– 242.
53. Passeron, T.,, M. C. Ndir,, C. Aubron,, and P. Hovette. 2004. Drug rash with eosinophilia and systemic symptoms (DRESS) due to streptomycin. Acta Dermatol. Venereol. 84: 92– 93.
54. Pavithran, K.,, and N. Vijayalekshmi. 1993. Thrombocytopenic purpura with tuberculous adenitis. Indian J. Med. Sci. 4 (10) : 239– 240.
55. Paydas, S.,, M. Ergin,, F. Baslamisli,, S. Yavuz,, S. Zorludemir,, B. Sahin,, and F. A. Bolat. 2002. Bone marrow necrosis: clinicopathologic analysis of 20 cases and review of the literature. Br. J. Haematol. 70 (4) : 300– 305.
57. Pereira, J.,, P. Hidalgo,, M. Ocqueteau,, M. Blacutt,, M. Marchesse,, Y. Nien,, L. Letelier,, and D. Mezzano. 2000. Glycoprotein Ib/IX complex is the target in rifampicin-induced immune thrombocytopenia. Br. J. Haematol. 110 (4) : 907– 910.
58. Prasad, R.,, S. Kant,, and D. K. Pandey. 1999. Rifampicin induced thrombocytopenia. J. Assoc. Physicians India 47: 252.
59. Quaye, I. 2008. Haptoglobin, inflammation and disease. Trans. R. Soc. Trop. Med. Hyg. 102: 735– 742.
60. Raj, M.,, and A. Agrawal. 2006. Inferior vena cava thrombosis complicating tuberculosis. N. Z. Med. J. 119 (1244): U2279.
61. Richards, E. M.,, J. M. Shneerson,, and T. P. Baglin. 1994. Thrombocyctopenia responding to empirical antituberculous therapy. Clin. Lab. Haematol. 16: 89– 90.
62. Robson, S. C.,, N. W. White,, I. Aronson,, R. Woollgar,, H. Goodman,, and P. Jacobs. 1996. Acute-phase response and the hypercoagulable state in pulmonary tuberculosis. Br. J. Haematol. 93: 943– 949.
63. Rosenberg, M. J.,, and L. W. Rumans. 1978. Survival of a patient with pancytopenia and disseminated coagulation associated with miliary tuberculosis. Chest 73: 536– 539.
64. Savage, P. J.,, R. P. Dellinger,, J. V. Barnes, et al. 1984. Pelger-Huet anomaly of granulocytes in a patient with tuberculosis. Chest 85: 131– 132.
65. Schecter, G. F.,, C. Scott,, L. True,, A. Raftery,, J. Flood,, and S. Mase. 2010. Linezolid in the treatment of multidrug-resistant tuberculosis. Clin. Infect. Dis. 50: 49– 55.
66. Selvaraj, P.,, N. Venkataprasad,, V. K. Vijayan,, R. Prabhakar,, and P. R. Narayanan. 1994. Procoagulant activity of bronchoalveolar lavage fluids taken from the site of tuberculosis lesions. Eur. Respir. J. 7 (7) : 1227– 1232.
67. Sharp, R. A.,, J. G. Lowe,, and R. N. Johnston. 1990. Antituberculous drugs and sideroblastic anaemia. Br. J. Clin. Pract. 44 (12) : 706– 707.
68. Siddiqui, M. A.,, and I. A. Khan. 2002. Isoniazid-induced lupus erythematosus presenting with cardiac tamponade. Am. J. Ther. 9 (2) : 163– 165.
69. Singh, K. J.,, G. Ahluwalia,, S. K. Sharma,, R. Saxena,, V. P. Chaudhary,, and M. Anant. 2001. Significance of haematological manifestations in patients with tuberculosis. J. Assoc. Physicians India 49: 790– 794.
70. Singh, R.,, M. M. Singh,, V. L. Lahiri, et al. 1987. Tuberculosis as a continuing cause of secondary amyloidosis in northern India. J. Indian Med. Assoc. 85 (11) : 328– 332.
71. Suárez Ortega, S.,, J. Artiles Vizcaino,, I. Balda Aguirre,, P. Melado Sánchez,, M. E. Arkuch Saade,, E. Ayala Galán,, and P. Betancor León. 1993. Tuberculosis as risk factor for venous thrombosis. An. Med. Interna 10 (8) : 398– 400.
72. Sunga, M. N., Jr.,, C. V. Reyes,, J. Zvetina,, and T. W. Kim. 1989. Resolution of secondary amyloidosis 14 years after adequate chemotherapy for skeletal tuberculosis. South. Med. J. 82: 92– 93.
73. Tan, B.,, C. Meinken,, M. Bastian,, H. Bruns,, A. Legaspi,, M. T. Ochoa,, S. Krutzik,, B. Bloom,, T. Ganz,, R. Modlin,, and S. Stenger. 2006. Macrophages acquire neutrophil granules for antimicrobial activity against intracellular pathogens. J. Immunol. 177: 1864– 1871.
74. Tarhan, G.,, F. Gümüşlü,, N. Yilmaz,, D. Saka,, I. Ceyhan,, and S. Cesur. 2006. Serum adenosine deaminase enzyme and plasma platelet factor 4 activities in active pulmonary tuberculosis, HIV-seropositive subjects and cancer patients. J. Infect. 52 (4) : 264– 268.
75. Tengku Muzaffar, T. M. S.,, A. R. Shalfuzain,, Y. Imran,, and M. N. Noor Haslina. 2008. Hematological changes in tuberculous spondylitis patients at the Hospital Universiti Sains Malaysia. Southeast Asian J. Trop. Med. Public Health 39 (4) : 686– 689.
76. Tereul, J. L.,, R. Matesanz,, F. Mampaso,, S. Lamas,, J. A. Herrero,, and J. Ortuňo. 1987. Pulmonary tuberculosis, cryoglobulinemia and immune complex glomerulonephritis. Clin. Nephrol. 27: 48– 49.
77. Tozkoparan, E.,, O. Deniz,, E. Ucar,, H. Bilgic,, and K. Ekiz. 2007. Changes in platelet count and indices in pulmonary tuberculosis. Clin. Chem. Lab. Med. 45: 1009– 1013.
78. Turken, O.,, E. Kunter,, M. Sezer,, R. Solmazgul,, E. Bozkanat,, A. Ozturk,, and A. Ilvan. 2002. Hemostatic changes in active pulmonary tuberculosis. Int. J. Tuberc. Lung Dis. 6: 927– 932.
79. Twomey, J. J.,, and B. S. Leavell. 1965. Leukemoid reactions to tuberculosis. Arch. Intern. Med. 116: 21– 28.
80. Vergne, I.,, J. Chua,, and V. Deretic. 2003. Mycobacterium tuberculosis phagosome maturation arrest: selective targeting of PI3P-dependent membrane trafficking. Traffic 4: 600– 606.
81. Viallard, J. F.,, M. Parren,, J. M. Boiron, et al. 2002. Reversible myelofibrosis induced by tuberculosis. Clin. Infect. Dis. 34: 1641– 1643.
82. Williams, W. J. 1990. Lymph node enlargement, p. 950–955. In W. J. Williams,, E. Beutler,, A. J. Ersley, et al. (ed.), Hematology, 4th ed. McGraw-Hill, New York, NY.
83. Zaharatos, G. J.,, M. A. Behr,, and M. D. Libman. 2001. Profound T-lymphocytopenia and cryptococcemia in a human immunodeficiency virus-seronegative patient with disseminated tuberculosis. Clin. Infect. Dis. 33 (11) : E125– E128.

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