Original Research Article
Year: 2018 | Month: March | Volume: 8 | Issue: 3 | Pages: 70-77
Study of Iron Metabolism in Pulmonary Tuberculosis Patients
Dr Sandhya Mishra1, Mrs Pallavi Taparia2, Dr Dharmveer Yadav3, Dr Suresh Koolwal4
1Professor, 2Ph d Scholar, 3Asso Professor,
Deptt of Biochemistry, SMS Medical College, Jaipur.
4Professor, Hosp for Chest diseases & SMS Medical College, Jaipur.
Corresponding Author: Dr Sandhya Mishra
Introduction: Iron deficiency anemia and Malnutrition is common in developing countries and is a major pre-disposing factor in Pulmonary Tuberculosis (PTB). Iron metabolism which is tightly regulated in normal condition is often found to be disturbed in various pathological conditions. Both deficiency and excess of free iron compromise cellular and immune functions and also affect disease susceptibility and outcome.
AIM: The aim of this work was to study iron metabolism in PTB patients in their relation to severity of disease and sputum bacterial load
Material and Method: 100 adult PTB patients (both male and female) were recruited from Institute of Respiratory Disease, Jaipur and 60 age matched healthy individuals served as controls for comparison. Standard diagnostic procedure was followed for PTB patients and Sputum positivity was assessed by counting number of Acid Fast Bacilli in sputum microscopically. After written consent, serum was used for investigating routine and specific Biochemical parameters i.e. serum Iron, Total Iron binding capacity, Transferrin and Ferritin for all subjects. Ferritin was analyzed by Chemiluminescence on Immulite 2000 (Siemens Co). Iron, TIBC, Transferrin and CRP were analyzed on fully automatic Biochemistry Analyzer. C- Reactive Protein was determined as indicator of systemic inflammation in PTB.
Result and Discussion: Serum Protein, Albumin, Iron, Transferrin and Transferrin Saturation were significantly decreased in PTB patients than controls. Protein malnutrition and Iron deficiency anemia are not just predisposing factors but also affect mortality and outcome of disease. Both Ferritin and CRP were significantly higher in PTB than Controls (p<0.001) due to their nonspecific rise in inflammation. Significant correlation of Ferritin and CRP with disease severity (r=0.49 and r=0.26 respectively) and with Sputum positivity (r=0.57 and r=0.62 respectively) suggest their potential in severity assessment. Sequestration of Iron in the form of Ferritin makes Fe non available to MTB and thus limits its growth and multiplication. Transferrin was also found to be correlated negatively and strongly to Disease severity (r=0.68).
Results: It was concluded that hemostatic mechanism was altered in PTB. Fe and its metabolites especially Transferrin and ferritin correlated to disease severity and sputum positivity. In other words, these can be used as indicator of disease severity or mortality risk.
Key words:Iron metabolism, Pulmonary Tuberculsis.