Serum ceruloplasmin albumin ratio as a prognostic marker in Pulmonary Tuberculosis patients.

Payal C. Gamit; Margeyi M. Mehta; A.T.Leuva

Volume : VI, Issue : IV, April - 2016

Serum ceruloplasmin albumin ratio as a prognostic marker in Pulmonary Tuberculosis patients.

Payal C. Gamit, Margeyi M. Mehta, A. T. Leuva

Abstract :

BACKGROUND: Pulmonary tuberculosis caused by mycobacterium tuberculosis is communicable disease of global importance. India has the highest number of TB cases in the world and it is leading cause of death because of its high mortality and morbidity due to the emergence of multi–drug resistant TB strains and HIV infection which reactivates latent TB making it lethal. Moreover, failure to diagnose TB early remains one of the primary hurdles in preventing the spread of this disease. While the treatment of TB is considered one of the most cost–effective interventions in DOTS (Directly Observed treatment) program, we are still without a fast and simple diagnostic and prognostic test that would be applicable in high–burden but resource–poor settings. In tuberculosis, the albumin content decreases while the globulin like Ceruloplasmin increases leading to high ceruloplasmin albumin ratio. The albumin fraction has been increased and the ceruloplasmin proved to decreases towards normal in the course of treatment . To help for an early detection and prognosis the serum ceruloplasmin albumin ratio can be of great help in a tertiary care hospital like SSG Hospital Baroda. METHOD: The study was carried out at the Clinical Chemistry Laboratory at S.S.G. Hospital and Medical College, Baroda. Ethical Clearance was obtained from the Institutional Ethics Committee for Human Research, Medical College and S.S.G. Hospital, Baroda. In this Prospective cohort Study,40 newly diagnosed pulmonary tuberculosis patients in the age group of 15 to 75 years attending to Pulmonary medicine OPD of S.S.G. hospital and patients from Urban health centre, Vadodara were selected as a case for study of serum ceruloplasmin albumin ratio and same patients were followed up after completion of treatment. For controls 40 age and sex matched healthy volunteers were taken. Serum ceruloplasmin was estimated by turbidimetric immunoassay and Serum albumin was estimated by omocresol green method on fully automated biochemistry analyzer. RESULTS: MEAN ± SD for S.CERULOPLASMIN, S.ALBUMIN and S.CERULOPLASMIN ALBUMIN ratio in newly diagnosed pulmonary TB patients and pulmonary TB patients after completion of treatment were 86 ± 10, 3052 ± 284, 0.028 ± 0.004 and 45 ± 6, 4325 ± 494, 0.01 ± 0.002 respectively. p value for S.CERULOPLASMIN, S.ALBUMIN and S.CERULOPLASMIN ALBUMIN ratio were <0.0001. CONCLUSION: There is a definite requirement of economic biochemical parameters in assisting the diagnosis and follow up of Pulmonary Tuberculosis specially in the lower socioeconomic starta. Therefore Serum ceruloplasmin albumin ratio may be used as a marker to assist diagnosis, effectiveness of treatment and prognosis of Pulmonary Tuberculosis patients.