Clinical characteristics of active tuberculosis with pulmonary thromboembolism.

Background: In this study, we summarized clinical characteristics in patients with active tuberculosis (ATB) complicated by pulmonary thromboembolism (PTE), to further determine the influencing factors of PTE in ATB patients.

Methods: The study population consisted of ATB patients who were first seen and hospitalized from January 2014 to January 2022 in Haihe Hospital. The diagnosis of PTE was confirmed by computed tomography pulmonary angiography (CTPA), and the ATB patients were divided into a test group with PTE and a control group without PTE in this study. The Padua score is a guideline-recommended validated tool for venous thromboembolism (VTE) risk assessment in medical patients. The two groups were retrospectively compared and analyzed by clinical characteristics, including gender, age, Padua score, clinical symptoms, tuberculosis (TB) classification, routine blood tests, coagulation indexes, inflammatory indexes, imaging manifestations, and rifampicin application, etc. RESULTS: There are 43 patients diagnosed with ATB complicated by PTE in this study, including 27 males (62.8%) and 16 females (37.2%), with a ratio of 1.69. Compared with the control group, test group showed higher Padua score, more frequent chest tightness and dyspnea, higher D-dimer, but with lower arterial partial pressure of carbon dioxide. Pathologically, more lobes in the test group patients had pulmonary lesions, with higher occurance in the lower and middle lobes, more image manifestations of pulmonary infarction and atelectasis. Lastly, CTPA traits showed that peripheral types are more than central types in the test group.

Conclusions: ATB patients should be alert to the occurrence of PTE and consider initiating anticoagulant therapy, if they have anemia, hypoproteinemia, increased D-dimer, increased inflammatory indicators, serious imaging, more pulmonary lobe involvement and lower lobe involvement.