Acute Phase Proteins and Stress Hormone Responses in Patients with Newly Diagnosed Active Pulmonary Tuberculosis

Despite the high burden of disease, there have been surprisingly few studies of the acute phase and plasma catecholamine/cortisol stress hormone responses in patients with active pulmonary tuberculosis. We wished to document acute phase reactant and stress hormone responses in patients with newly diagnosed, active pulmonary tuberculosis and to compare these responses to those of a group of surgical/medical cases with conditions other than tuberculosis. This was a prospective study of consecutive patients with newly diagnosed pulmonary tuberculosis, admitted to a tertiary hospital in Johannesburg, South Africa, documenting demographic, clinical, routine laboratory, acute phase protein and stress hormone responses relative to those of the control group. TB patients had a higher body temperature and pulse rate, as well as a platelet counts, ferritin, CRP and dopamine levels, with a tendency to higher cortisol levels compared to the control group. Conversely, they had a lower BMI, haemoglobin, leucocyte count, MCV and epinephrine levels than the control group. Patients with active pulmonary tuberculosis were documented to mount an acute stress response which was more intense than that of a control group of patients with surgical/medical conditions other than tuberculosis.