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1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections

BACKGROUND: Limited data are available regarding laboratory abnormalities in patients with pulmonary Mycobacterium avium complex (MAC) disease. METHODS: We included patients without cystic fibrosis who had pulmonary MAC and met ATS/IDSA disease criteria from the Northwest NTM Biobank with a complete...

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Autores principales: Varley, Cara D, Henkle, Emily, Strnad, Luke, Ku, Jennifer, Brunton, Amanda, Winthrop, Kevin L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808944/
http://dx.doi.org/10.1093/ofid/ofz360.1239
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author Varley, Cara D
Henkle, Emily
Strnad, Luke
Ku, Jennifer
Brunton, Amanda
Winthrop, Kevin L
author_facet Varley, Cara D
Henkle, Emily
Strnad, Luke
Ku, Jennifer
Brunton, Amanda
Winthrop, Kevin L
author_sort Varley, Cara D
collection PubMed
description BACKGROUND: Limited data are available regarding laboratory abnormalities in patients with pulmonary Mycobacterium avium complex (MAC) disease. METHODS: We included patients without cystic fibrosis who had pulmonary MAC and met ATS/IDSA disease criteria from the Northwest NTM Biobank with a complete blood count (CBC) 6 months prior and up to 30 days after study enrollment. The biobank is a cohort of patients with Nontuberculous mycobacterium (NTM) infections identified through statewide laboratory surveillance and OHSU regional referral NTM clinic; a complete clinical history is collected by chart review at enrollment. We evaluated the proportion of pulmonary MAC patients with abnormal laboratory tests. We examined differences using a chi-square test between patients who were antimycobacterial treatment naïve, on therapy at enrollment or previously treated, in addition to cavitary and non-cavitary disease and those who also had previous sputum isolation of additional organisms (co-isolation). RESULTS: 147 patients had CBCs available; 112 (76.2%) were female with a median age of 69 years (22–88 years). 64 (43.5%) were antimycobacterial treatment naïve, 65 (44.2%) were on therapy at enrollment and 18 (12.2%) were previously treated. Lymphocyte count was below normal in 105 (73.4%) patients; 70 (49.3%) had lymphocyte counts below 1500 cells/mL and 27 (18.9%) were lymphopenic. Elevated monocyte percent was seen in 54 (37.2%) patients. Lymphopenia was more common in those on therapy, P = 0.01. There were no predominant laboratory abnormalities in 108 patients with metabolic panels. 34 patients had a c-reactive protein (CRP) collected, which was elevated, after age and gender correction, in 31 patients (91.2%). There was no significant difference between treatment groups. Eleven patients had cavitary disease with no differences in laboratory values compared with those with non-cavitary disease. Patients with co-isolation were more likely to be anemic (P = 0.03), have thrombocytosis (P = 0.04) and were less likely to have a monocytosis (P = 0.03). CONCLUSION: A large proportion of patients with pulmonary MAC disease have low lymphocyte counts, elevated monocyte percent and CRP. Further evaluation of the meaning of these abnormalities as well as changes during therapy is needed. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68089442019-10-28 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections Varley, Cara D Henkle, Emily Strnad, Luke Ku, Jennifer Brunton, Amanda Winthrop, Kevin L Open Forum Infect Dis Abstracts BACKGROUND: Limited data are available regarding laboratory abnormalities in patients with pulmonary Mycobacterium avium complex (MAC) disease. METHODS: We included patients without cystic fibrosis who had pulmonary MAC and met ATS/IDSA disease criteria from the Northwest NTM Biobank with a complete blood count (CBC) 6 months prior and up to 30 days after study enrollment. The biobank is a cohort of patients with Nontuberculous mycobacterium (NTM) infections identified through statewide laboratory surveillance and OHSU regional referral NTM clinic; a complete clinical history is collected by chart review at enrollment. We evaluated the proportion of pulmonary MAC patients with abnormal laboratory tests. We examined differences using a chi-square test between patients who were antimycobacterial treatment naïve, on therapy at enrollment or previously treated, in addition to cavitary and non-cavitary disease and those who also had previous sputum isolation of additional organisms (co-isolation). RESULTS: 147 patients had CBCs available; 112 (76.2%) were female with a median age of 69 years (22–88 years). 64 (43.5%) were antimycobacterial treatment naïve, 65 (44.2%) were on therapy at enrollment and 18 (12.2%) were previously treated. Lymphocyte count was below normal in 105 (73.4%) patients; 70 (49.3%) had lymphocyte counts below 1500 cells/mL and 27 (18.9%) were lymphopenic. Elevated monocyte percent was seen in 54 (37.2%) patients. Lymphopenia was more common in those on therapy, P = 0.01. There were no predominant laboratory abnormalities in 108 patients with metabolic panels. 34 patients had a c-reactive protein (CRP) collected, which was elevated, after age and gender correction, in 31 patients (91.2%). There was no significant difference between treatment groups. Eleven patients had cavitary disease with no differences in laboratory values compared with those with non-cavitary disease. Patients with co-isolation were more likely to be anemic (P = 0.03), have thrombocytosis (P = 0.04) and were less likely to have a monocytosis (P = 0.03). CONCLUSION: A large proportion of patients with pulmonary MAC disease have low lymphocyte counts, elevated monocyte percent and CRP. Further evaluation of the meaning of these abnormalities as well as changes during therapy is needed. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6808944/ http://dx.doi.org/10.1093/ofid/ofz360.1239 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Varley, Cara D
Henkle, Emily
Strnad, Luke
Ku, Jennifer
Brunton, Amanda
Winthrop, Kevin L
1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title_full 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title_fullStr 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title_full_unstemmed 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title_short 1375. Laboratory Abnormalities Among Patients with Pulmonary Mycobacterium avium Complex Infections
title_sort 1375. laboratory abnormalities among patients with pulmonary mycobacterium avium complex infections
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808944/
http://dx.doi.org/10.1093/ofid/ofz360.1239
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