Diagnosis of cytolithic syndrome in patients with tuberculosis of lungs
DOI:
https://doi.org/10.11603/mcch.2410-681X.2017.v0.i1.7684Keywords:
first diagnosed lung tuberculosis, markers of cytolytic syndrome.Abstract
Introduction. The liver is one of the most important organs of the human body, performing a number of important functions. Among the common liver diseases, infiltrative pathologies we distinguished: fatty degeneration, lymphomas, amyloidosis, sarcoidosis and tuberculosis. Characterizing liver disease, the manifestations of disorders are divided into syndromes that help to diagnose a particular disease of the liver and determine its causes. In particular – the cytolytic syndrome (CS).
The aim of the study – to examine the CS markers in the case of liver dysfunction in patients with newly diagnosed lung tuberculosis prior to treatment and after two months of therapy with first-line anti-tuberculosis drugs.
Methods of the research. Two groups of people were examined: the 1st control group of practically healthy donors – 34 people; and the 2nd – patients with newly diagnosed pulmonary tuberculosis prior to treatment and after two months of therapy with first-line anti-tuberculosis drugs (31 people). All patients underwent standard biochemical blood tests, ultrasound of the liver in dynamics. The spectrum of biochemical blood test parameters included determination of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and γ-glutamyltranspeptidase (GGTP).
Results and Discussion. The obtained data testifying to occurrence of CS in newly diagnosed tuberculosis patients before the start of treatment are confirmed by the tendency to increase the levels of AST and GGTP. Especially such changes are observed after intensive therapy with antituberculous drugs. There are likely changes in such markers as ALT, LDH and GGTP.
Conclusions. It is established that tuberculous intoxication can affect the functional state of the liver. After prolonged treatment of patients with pulmonary tuberculosis, an increase in the indices of such markers of cytolysis as ALT, LDH and GGTP is observed. Disturbance of liver function during therapy may be due to the hepatotoxic effect of anti-tuberculosis drugs, which necessitates the appointment for patients hepatoprotectors.
References
Vyalov, S.S. (2013). Sindrom tsitoliza v gastroenterologii: taktika vedeniya patsiyentov v obshchey praktike [Cytolysis syndrome in gastroenterology: tactics of management of patients in general practice]. Gastroenterologiya. prilozheniye k zhurnalu Consilium Medicum – Gastroenterology. Supplement to the Journal Consilium Medicum, (1), 42-48 [in Russian].
Perelik zakhvoryuvan pechinky, yikh symptomy ta diahnostyka [Elektronnyi resurs]. Rezhym dostupu do resursu: http://medprice.com.ua/ukr/articles/perelik-zahvoryuvan-pechinki-yih-simptomi-ta-diagnostika-4708.html. [in Ukrainian].
Balasanyants, G.S., & Sukhanov, D.S. (2011). Pobochnyye deystviya protivotuberkuleznykh preparatov i metody yikh ustraneniya [Adverse effects of antituberculous drugs and methods of their eliminaton]. St. Petersburg: Taktik-Studio [in Russian].
Ana Tavares e Castro, Mariana Mendes, Sara Freitas, Paulo Cravo Roxo (2015). Incidence and risk factors of major toxicity associated to first-line antituberculosis drugs for latent and active tuberculosis during a period of 10 years. Revista Portuguesa de Pneumologia (English Edition). 21 (3), 144-150.
Lee, S.S., Lee, C.M., Kim, T.H., Kim, J.J., Lee, J.M., Kim, H.J., … Kim, D.Y. (2016). Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis. Int. J. Tuberc. Lung Dis., 20(6), 800-805.
Baghaei, P., Tabarsi, P., Chitsaz, E., Saleh, M., Marjani, M., Shemirani, S., … Masjedi, M. (2010). Incidence, clinical and epidemiological risk factors, and outcome of drug-induced hepatitis due to antituberculous agents in new tuberculosis cases. Am. J. Ther., 17 (1), 17-22.
Halan, I.O., Pavlenko, O.M., Potaychuk, V.I., Zdoryk, I.F. (2008) Vplyv antymikobakterialnoi terapii na dynamiku deyakykh pokaznykiv bilkovoho obminu ta hepatobiliarnoi systemy u khvorykh na vpershe diahnostovanyi tuberkuloz lehen. Ukrainskyi pulmonolohichnyi zhurnal – Ukrainian Pulmonological Journal, (3), 70-72 [in Ukrainian].
Koroleva, M.V. (2015). Farmakoepidemiologicheskaya i kliniko-laboratornaya kharakteristika lekarstvenno-indutsirovannogo porazheniya pecheni pri tuberkuleze. Zhurnal infektologii – Journal of Infectology, 7 (4), 44-50 [in Ukrainian].
Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy. Tuberkuloz u doroslykh / Nakaz MOZ Ukrayiny № 620 vid 04.09.2014 r [Unified clinical protocols of primary, secondary (specialized) and tertiary (highly specialized) medical care. Tuberculosis in Adults / Decree of MOP of Ukraine No.620 from 04.09.2014]. Retreived from: https://medprosvita.com.ua/nakaz-moz-ukrayini-vid-04-09-2014-n-620-pro-zatverd 2/ [in Ukrainian].
