Sedimentation rate and suPAR in relation to disease activity and mortality in patients with tuberculosis

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DOI

  • H Schulman, Department of Infectious Diseases, Linköping University Hospital, Linköping.
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  • K Niward, Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • E Abate, Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
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  • J Idh, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University.
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  • P Axenram, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • A Bornefall, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • S Forsgren, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • J Jakobsson, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • C Öhrling, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • M Kron, Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • L Brudin, Department of Clinical Physiology, Kalmar County Hospital, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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  • E Diro, Department of Internal Medicine, University of Gondar, Gondar.
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  • A Getachew Kebede, Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
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  • J Paues, Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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  • J Bruchfeld, Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
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  • C Wejse
  • O Stendahl, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University.
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  • T Schön, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University, Department of Infectious Diseases and Clinical Microbiology, Kalmar County Hospital, Linköping University, Linköping, Sweden.
OBJECTIVE: To investigate how levels of the soluble urokinase plasminogen activator receptor (suPAR) and erythrocyte sedimentation rate (ESR) correlate with disease activity and prognosis in pulmonary tuberculosis (PTB).DESIGN: This was a retrospective analysis of patients with active PTB (n = 500) in Gondar, Ethiopia, for whom the suPAR (n = 301) and ESR (n = 330) were analysed at the start of treatment. Both biomarkers were available for 176 patients. Human immunodeficiency virus (HIV) status, chest X-ray (CXR) findings, classification according to the clinical TBscore and treatment outcome were all recorded.RESULTS: In a multivariable logistic regression analysis adjusted for age, sex and HIV status, surrogate markers of disease activity such as advanced CXR patterns correlated with increased levels of suPAR (adjusted OR [aOR] 8.24, P < 0.001) and of ESR (aOR 1.63, P = 0.030), whereas ESR only correlated significantly with a TBscore >6 points. Increased levels of both suPAR and ESR were associated with unsuccessful treatment outcomes (aOR 2.93, P = 0.013; aOR 2.52, P = 0.025). The highest quartile of suPAR (aOR 13.3, P = 0.029) but not ESR levels correlated independently with increased mortality.CONCLUSION: SuPAR and ESR levels correlate with disease activity in PTB; however, the clinical role of these potentially prognostic biomarkers needs to be verified in prospective studies.
OriginalsprogEngelsk
TidsskriftInternational Journal of Tuberculosis and Lung Disease
Vol/bind23
Nummer11
Sider (fra-til)1155-1161
Antal sider7
ISSN1027-3719
DOI
StatusUdgivet - 1 nov. 2019

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