Article
Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes
Registro en:
BEZERRA, André Luiz et al. Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes. J. Bras Pneumol. v. 48, n. 6, e20210505, p. 1 - 9, Aug. 2022.
1806-3713
10.36416/1806-3756/e20210505
Autor
Bezerra, André Luiz
Moreira, Adriana da Silva Rezende
Gonçalves, Lorrayne Isidoro
Lara, Carla F. dos Santos
Amorim, Gustavo
Silva, Elisangela C.
Kritski, Afrânio Lineu
Carvalho, Anna Cristina C.
Resumen
Objective: To analyze the association of dysglycemia with clinical, laboratory, and
radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as
with their tuberculosis treatment outcomes. Methods: This was a longitudinal study
involving 140 patients diagnosed with PTB (positive cultures for Mycobacterium
tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were
evaluated at diagnosis (M0), after completing the second month of treatment (M2), and
at the end of treatment (MEND). At M0, the patients were classified into three groups:
normoglycemia+PTB (NGTB); pre-diabetes mellitus+PTB (PDMTB), and diabetes
mellitus+PTB (DMTB), in accordance with glycated hemoglobin levels (< 5.7%, 5.7%-
6.4%, and ≥ 6.5%, respectively). Treatment outcomes were classified as favorable (cure
or treatment completion) and unfavorable (death, loss to follow-up, or treatment failure).
Results: In our sample, 76 patients (61.4%) had dysglycemia, 20 of whom (14.3%) had
DM at M0. The patients with dysglycemia, in comparison with those in the NGTB group,
more frequently presented with positive sputum smear microscopy (94.2% vs. 75.9%;
p = 0.003); cavities (80.2% vs. 63.0%; p = 0.03); bilateral lesions (67.4% vs. 46.0%;
p = 0.02); and higher median of affected thirds of the lungs (3.0 vs. 2.0; p = 0.03) on
chest radiography. No significant differences regarding outcomes were found among
the groups, but tuberculosis lethality was higher in the DMTB group than in the PDMTB
and NGTB groups (20% vs. 2.2%). Conclusions: PTB patients with dysglycemia had
laboratory and radiographic manifestations indicative of more advanced disease, and the
risk of death was higher in the DMTB group. These findings reinforce the recommendation
for early screening for DM in patients with newly diagnosed tuberculosis in order to
reduce the risk of death during treatment.
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