Association of deep venous thrombosis with pulmonary tuberculosis

Abstract

Introduction: Thromboembolic complications associated with infection by Mycobacterium tuberculosis have been reported in the literature that occurred in 1.5–3.4% of TB infection, which is a risk factor for deep vein thrombosis (DVT) related to the hypercoagulable state secondary to the inflammatory state. Objective: We report in this study the pathophysiological, therapeutic, epidemiological, and clinical aspects, of this association. Methods: This is a retrospective study done in our department between January 2010 and May 2013. It is about 30 cases of confirmed pulmonary tuberculosis associated with deep vein thrombosis. Results: It is about 21 men and 9 women. Pulmonary tuberculosis was confirmed by the presence of acidoalcoolo-resistant bacillus on the sputum on a direct examination of 25 cases and bronchial aspiration in 5 cases. All patients had extensive radiological lesions. Phlebitis occurred within a mean of 17 days after the diagnosis of tuberculosis. It was confirmed by venous doppler deep ultrasound of inferior membres. All patients received anti-tuberculosis drugs in association with anticoagulant treatment. Etiologic investigations showed positive anti-phospholipid antibodies in one case, and decrease in C and S proteins in 2 patients in which phlebitis was complicated by arterial pulmonary embolism. We had difficulties in controlling prothrombin level in 9 cases and we prescribed low molecular weight heparin for 6 months in two cases. Conclusion: Thromboembolic disease is diagnosed systematically in the TB patients because of the risk of this complication particularly in extensive and severe forms. Prophylactic anticoagulation finds its indications in these forms.

Keywords

• Tuberculosis
• Thrombosis
• Anticoagulant
• Treatment