The some clinical issues of chronic anemia among tuberculosis patients

Abstract

Background: Mixed-type chronic anemia is most common in TB patients caused by multiple factors such as mycobacterial endotoxin-induced hematopoiesis suppression, chronic tuberculosis intoxication and malnutrition. Also, it’s can be caused by the combination of anti-TB drug-induced liver injury, drugs that suppressive effects on hematopoiesis such as rifampicin and linezolid.8 In drug-susceptive TB, anemia can be spontaneously recovery during treatment, often without specific corrective treatment. However, in drug-resistant forms, there is a risk that drug-induced anemia may worsen during treatment if without management.16 There is a lack of research on this field in our country, which is the basis of necessary for our study. Goal: To study the usage of linezolid among drug-resistant TB patients and the data on anemia caused by it. Method: Our analysis was performed on patient’s data on laboratory-confirmed drug resistance (including RR/MDR-TB, pre-XDR, and XDR-TB) and clinically diagnosed drug-resistant TB cases in Ulaanbaatar by descriptive study design. Result: By the end of 2020, 191 cases of RR / MDR-TB and XDR-TB were under TB treatment control, of which 116(60.7%) were under control in Ulaanbaatar. The mean age of the study participants was 36±16.09 years, and the sex ratio was 69(59.5%) and 47(40.5%). 10(8.6%) of the participants had clinically confirmed TB cases. Of these, 54(46.5%) were new cases and the rest had previously been treated cases. In terms of drug resistance, 98 (85.5%) cases were RR/ MDR-TB and 92(79.3%) cases were pulmonary TB. 52(45%) are in the Bayanzurkh and Songinokhairkhan districts of the capital city. Of these 116 cases, 37(31.9%) had a treatment regimen with Linezolid (Lzd) and no adverse events of Linezolid-induced myelosuppressive anemia were reported. Conclusion: Linezolid is used in the treatment regimen of 1/3 of drug-resistant TB patients. The lack of detection, registration, and reporting of the drug-induced myelosuppressive anemia is an issue that needs to be addressed.