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.
Keywords
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References
- Endoscopic and clinical responses to anti-tubercular therapy can differentiate intestinal tuberculosis from Crohn’s disease.Aliment Pharmacol Ther. 2017; 45: 27-36
- Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis.Ther Adv Infect Dis. 2017; 4: 3-9
- Anorectal tuberculosis.Proc R Soc Med. 1969; 62: 1227-1230
- High faecal calprotectin levels in intestinal tuberculosis are associated with granulomas in intestinal biopsies.Infect Dis. 2015; 47: 137-143
- Faecal calprotectin levels differentiate intestinal from pulmonary tuberculosis: an observational study from Southern India.United European Gastroenterol J. 2014; 2: 397-405
- Prevalence and clinical impact of vitamin D deficiency on abdominal tuberculosis.Ther Adv Infect Dis. 2017; 4: 83-86
- Six-month therapy for abdominal tuberculosis.Cochrane Database Syst Rev. 2016; 11: CD012163
- C-reactive protein, Neopterin and Beta2 microglobulin levels pre and post TB treatment in The Gambia.BMC Infect Dis. 2016; 16: 115
- Serum biomarkers of treatment response within a randomized clinical trial for pulmonary tuberculosis.Tuberculosis (Edinb). 2015; 95: 415-420
- Diagnostic and prognostic value of serum C-reactive protein for screening for HIV-associated tuberculosis.Int J Tuberc Lung Dis. 2013; 17: 636-643
- Sustained elevated levels of C-reactive protein and ferritin in pulmonary tuberculosis patients remaining culture positive upon treatment initiation.PLoS One. 2017; 12e0175278
- A model to rule out smear-negative tuberculosis among symptomatic HIV patients using C-reactive protein.Int J Tuberc Lung Dis. 2012; 16: 1247-1251
- A simple C-reactive protein measurement for the differentiation between tuberculous and malignant pleural effusion.Respirology. 2004; 9: 66-69
- Adipokines: molecular links between obesity and atheroslcerosis.Am J Physiol Heart Circ Physiol. 2005; 288: H2031-H2041
- C-reactive protein: a critical update.J Clin Invest. 2003; 111: 1805-1812
- Response of tuberculous stricture to antituberculous treatment.Gut. 1988; 29: 62-69
- Routine diagnosis of intestinal tuberculosis and Crohn’s disease in Southern India.World J Gastroenterol. 2014; 20: 5017-5024
- C-reactive protein and systemic lupus erythematosus.Arthritis Rheum. 2008; 59: 1814-1820
Article info
Publication history
Published online: December 19, 2017
Accepted:
December 11,
2017
Received in revised form:
December 10,
2017
Received:
September 10,
2017
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
