الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 160 |  |  |
| | | from | 160 | | |
Abstract
This work was carried out to estimate serum neopterin levels in patients with active pulmonary tuberculosis and healthy healthcare workers who had close contact with patients to investigate whether it can be used in the diagnosis of LTBI and to monitor the response to AntiTB therapy during the course of treatment.
The study included 50 subjects categorized into 3 groups:
Group 1: Included 20 patients of newly diagnosed active pulmonary tuberculosis were examined in two occasion:
a- Before treatment. b-After two months of treatment.
Group 2: Included 20 healthy health care workers.
Group 3: Included 10 subjects, who were free from any clinical and/or inflammatory conditions.
The enrolled subjects were subjected to the following:
6) Full medical history taking
7) Complete clinical examination
8) Chest x-ray.
9) Serum neopterin level was evaluated by enzyme-linked immunosorbent assay kit (ELISA).
10) Group 1 was diagnosed by positive clinical and radiological findings, positive sputum smear or bronchial aspirate using Ziehl-Neelsen technique for acid-fast bacilli and/ or positive sputum cultures on Lowenstein-Jensen media. Patients were examined in 2 occasions by sputum smear, chest x-ray and serum neopterin.
(a) Newly diagnosed pulmonary TB patients (hadn’t received anti-TB treatment).
(b) Two months after treatment.
11) Group 2 had no clinical, laboratory, or radiological evidence of active pulmonary tuberculosis, other infections, or inflammatory conditions. Intradermal skin testing was performed according to the standard technique (Mantoux technique). All tuberculin skin tests (TSTs) were administered and readed by a chest diseases specialist.
The results showed that:
1. There was statistically significant increase in the mean value of serum neopterin levels in tuberculous group before treatment(121.89 + 104.96 nmol/L) over those in tuberculous group after two months of treatment (41.77 + 19.80), Those in HCWs group (31.57 + 55.73 nmol/L) and those in control group (12.19 + 9.38 nmol/L). Also significant increase of those of HCWs group and tuberculous group after two months of treatment over those in control group (P<0.001).
2. There was non statistically significant difference between males and females regarding serum neopterin levels in tuberculous, HCWs and control groups (p> 0.05).
3. There was non-significant positive correlation between serum neopterin and age in tuberculous, HCWs and control groups. As serum neopterin levels increases above age of fourty and decreases below.
4. There was non-significant positive correlation in serum neopterin levels in tuberculous patients before treatment with far-advanced and moderate lesions than minimal lesions.
5. There was non-significant decrease in serum neopterin levels in smokers than in non-smokers in tuberculous group.
6. There was non-significant elevation of serum neopterin levels in bacteriologically positive than negative in tuberculous group before and after treatment.
7. There was non-significant elevation in serum neopterin levels in diabetics than non diabetics in tuberculous and healthcare workers groups.
8. There was non significant difference in serum neopterin levels between hypertensive and non hypertensive in tuberculous and healthcare worker groups.
9. There was non- significant elevation of serum neopterin levels in TST-positive than TST-negative in HCWs group.
CONCLUSION AND
RECOMMENDATIONS
• In tuberculous patients there is systemic elevation of neopterin levels suggesting increase in T-lymphocytic function.
• Tuberculous group had the highest values of neopterin suggesting remarkable immunologic response than other groups.
• Higher serum neopterin levels in Health Care Workers suggesting Latent Tuberculosis Infection.
• Decrease in serum neopterin levels after two menthes of ttt suggesting effective and appropriate therapy.
• Neopterin evaluation is a good parameter with other diagnostic methods in diagnosis and follow up of tuberculosis.
A wide scale study of neopterin in active tuberculosis and Latent Tuberculosis Infection for diagnosis and follow up during therapy is recommended.