Erythrocyte Sedimentation Rate เท Smear Positive And Smear Negative Pulmonary Tuberculosis
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Abstract
Background: Erythrocyte Sedimentation Rate (ESR) is extremely high in patients with tuberculosis, but in smear positive and negative pulmonary tuberculosis it is unknown.
Objectives: To study ESR in patients with smear positive and smear negative pulmonary tuberculosis and the association of ESR and grading of sputum smear microscopy results.
Method: Review medical records of patients with pulmonary tuberculosis who had sputum smear microscopy results, ESR and were treated from January 2009 to December 2010 in Sangkha community hospital, Surin Province, Thailand
Result: 116 patients were enrolled, 61 cases were males (52.6%) and 55 cases were females (47.4%). The average age is 63.8 years (male 63.3 years, female 64.3 years). There were sputum smear positive 41 cases (35.3%), 19 cases were males and 22 cases were females. The average age of this group is 62.4 years. Patients with sputum smear negative were 75 cases (64.7%), 42 cases were males and 33 cases were females. The average age of this group is 64.5 years. There are no difference of number of cases and the age between this two groups (p=0.324 and p=0.483 respectively). Mean ESR in male is 95.34 mm/hr and in female is 106.96 mm/hr and its difference is statistically significant (P=0.007). Mean ESR in patients with sputum smear negative is 100.57 mm/hr and 101.37 mm/hr in sputum smear positive patients. There are no difference (P=0.862) between this two groups. in patients with sputum smear positive group, AFB 1+ is found in the most cases (39%) then AFB 2+ and AFB 3+ respectively, ESR between this group is not significantly different (P=0.246). Mean ESR at any given age is not significantly different in both sputum smear positive and sputum smear negative group (p=0.217 and p=0.086 respectively)
Conclusions: Erythrocyte Sedimentation Rate in pulmonary tuberculosis is extremely high regardless of the sputum smear microscopy result and its grading. It could be helpful in differential diagnosis of an adult patient who is highly suspected of having pulmonary tuberculosis and had sputum smear negative especially in an area where a sputum culture is unavailable
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