Objective: Documentation of hematologic findings in children w/TB. Methods: Children w/TB enrolled prospectively were evaluated at presentation, 6 wks, 3 mos., including physical exam (w/nutritional anthropometry), chest roentgenogram, complete blood count and biochemical profile. Age-defined normal ranges were used for hematologic variables, which were correlated w/category of TB (in terms of clinical, roentgenographic, microbiologic findings, and severity of disease), nutritional status, biochemical findings, and outcome. Iron and folate Rx were used when indicated. Results: 100 pts, median age 39 mo. (range 3-171); all had pulmonary TB, 21% also had extrapulmonary TB. The wide spectrum of hematologic findings will be described in detail; selected findings follow, presented as median (range),% high*/low** for age: Table Miliary/other extrapulmonary TB was associated w/significantly lower Hgb and RBC indices and higher platelets and RDW; patients in these categories had poorer nutritional status (low weight z-score, Vit. A, pre-albumin, albumin, physical signs of malnutrition). Indicators of poor nutritional status were significantly associated w/abnormalities in all hematologic measures; low albumin was the most important determinant. Neutrophilia was predominant at presentation; lymphocytosis at 6 wks and 3 mos. Monocytosis was present in 19% at presentation. Eosinophilia was present in 21%, 31%, and 37% at the 3 evaluations, respectively, and was significantly more pronounced in culture-positive TB (43% of cohort) but not in miliary/extrapulmonary diseaseper se; there was a negative correlation between nutritional status and eosinophil response. No hematologic variable was predictive of disease outcome (reflecting overall good response to anti-TB Rx). Most hematologic abnormalities resolved during the follow-up period. Conclusion: Hematologic abnormalities are common in children with TB and are not predictive of outcome; nutritional status is an important determinant of abnormalities; resolution occurs with anti-TB and hematinic therapy; eosinophilia is correlated with culture-positive disease and becomes more prevalent later in TB.

Table 1
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