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3.8 Nonspecific abnormalities associated with pulmonary tuberculosis.

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Counted here biochemical parameters as a rule correlate with severity of tuberculosis.

Anemia.
Many patients with severe or long-standing tuberculosis develop mild «anemia of chronic disease».

Erythrocyte sedimentation rate (ESR).
Commonly see elevations into range of 40-80 mm/hr. Usually declines with treatment.

Albumin.
Low concentrations associated with chronic, wasting illness and more severe course, prolonged fever, and debility.

Globulin and glycoprotein.
Levels of globulin and glycoproteins (alfa-2 and gamma fractions) are increased.

Serum sodium.
Hyponatremia usually secondary to syndrome of inappropriate antidiuretic hormone secretion because of pulmonary involvement.

Abnormal liver function tests (LFTs).
Abnormal LFTs may result from hepatic tuberculosis, nonspecific inflammatory effect, or chronic passive congestion caused by cor pulmonale in far-advanced disease. [Occasionally related to existent alcohol abuse or viral hepatitis.]

Leukocytosis.
Most common pattern is modest increase in WBC count without left shift. Monocytosis is in distinct minority. Eosinophilia very rare.

Hypercalcemia.
Modest elevations of serum calcium are seen in significant proportion of patients receiving supplemental calcium and/or vitamin D; rare without such repletion.

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