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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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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. |
format | Online Article Text |
id | pubmed-6808944 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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