Diagnostic Evaluation of Alpha Tumor Necrosis Factor and Iron Profile in Newly Diagnosed Pulmonary Tuberculosis with and Without Anemia

Tuberculosis is the 9th leading cause of deaths worldwide. In chronic diseases such as pulmonary tuberculosis (PTB), inflammation due to bacterial burden play a vital role in patho-physiology of anaemia. Functions of erythropoietin (EPO) is affected by inflammation. The present study was an analytical type of case control study. The study included 100 newly diagnosed anaemic PTB cases and 50 newly diagnosed non anaemic PTB controls.  PTB was confirmed by microscopic examination of sputum specimen for the detection of Acid-Fast Bacilli (AFB). Both cases and controls were subjected to iron profile and serum α-TNF were analysed by ELISA method. Significantly higher levels of α-TNF(214.56±82.30) was observed in anemic PTB cases than that of non-anemic PTB cases (p<0.001). Iron profile was also found significantly higher in anaemic PTB group in non anaemic PTB group. Significantly inverse correlation was observed between α-TNF and iron (r=-0.257, p<0.05) and α-TNF and Ferritin (r=-0.202, p<0.05) and Iron and Ferritin in both the groups. Increased α-TNF associated with increased bacterial burden and relatively decreased Iron. Cytokine-mediated defence against microbial pathogen causes effective withholding of iron within macrophages which affects erythropoiesis