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. 2019 Jun;51(2):142-149.
doi: 10.3947/ic.2019.51.2.142.

Thromboembolism in Mycobacterium tuberculosis Infection: Analysis and Literature Review

Hyerim Ha  1   2 , Ki Hwan Kim  3 , Jin Hyun Park  4 , Jung Kyu Lee  5 , Eun Young Heo  5 , Jin Soo Kim  4 , Deog Kyeom Kim  5 , In Sil Choi  4 , Hee Soon Chung  5 , Hyo Jeong Lim  6
Affiliations

Thromboembolism in Mycobacterium tuberculosis Infection: Analysis and Literature Review

Hyerim Ha et al. Infect Chemother. 2019 Jun.

Abstract

Background: Tuberculosis is associated with hypercoagulation; however, there are few reports of cases thromboembolism and tuberculosis at the same time in the real world. The purpose of this study was to report the incidence and clinical course of thromboembolism in patients diagnosed with tuberculosis.

Materials and methods: We retrospectively analyzed the data of patients who were diagnosed with both tuberculosis and thromboembolism including pulmonary thromboembolism (PTE) or deep vein thrombosis (DVT) at Seoul National University Boramae Medical Center from January 2000 through March 2015.

Results: Among the 7905 tuberculosis patients, 49 (0.6%) exhibited PTE, DVT, or both at or after the time of tuberculosis diagnosis. All patients treated for tuberculosis started with isoniazid, ethambutol, rifampicin, and pyrazinamide. Eight patients were switched to treatment with second-line medication because of resistance or adverse events. About half of the patients (n = 21, 44.7%) had thrombosis at the time of tuberculosis diagnosis. Of 48 patients treated for thromboembolism, 36 received warfarin. A total of 20 patients improved symptom caused by thrombosis, and 10 patients were confirmed cure by image study such as computed tomography or doppler ultrasonography. Eight patients who were treated with warfarin had persistent thrombosis. Five patients (10.2%) experienced major bleeding that required hospitalization. All of these bleeding events were associated with warfarin therapy.

Conclusions: Careful attention to PTE/DVT is needed at the time of diagnosis of tuberculosis and during anti-tuberculosis therapy. Warfarin therapy administered with anti-tuberculosis medication requires frequent monitoring to prevent major bleeding.

Keywords: Deep vein thrombosis; Pulmonary embolism; Thromboembolism; Tuberculosis.

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Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1. Pulmonary thromboembolism/deep vein thrombosis incidence of tuberculosis and treatment.
The incidence of PTE/DVT and treatment pattern of tuberculosis and thromboembolism was visualized in this figure. PTE, pulmonary thromboembolism; DVT, deep vein thrombosis.
See this image and copyright information in PMC

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