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TUBERCULOSIS INFECTION DURING CHRONIC PANCREATITIS: INCIDENCE AND RISK FACTORS

Barbu, S. T.; Cazacu, M.

doi: 10.1097/01.mpa.0000297668.75793.91
Abstracts: Abstracts of Papers Submitted to the 38th Annual Meeting of the American Pancreatic Association, November 1-3, 2007, Chicago, Illinois
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IV-th Surgical Clinic, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj-Napoca, Romania.

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Introduction:

Tuberculosis is a major threat in Romania (incidence more than 10 times that of western countries). Tuberculosis infection occurring during chronic pancreatitis (CP) is jeopardizing the life of the malnourished,debilitated patients. Purpose: to assess the incidence and identify risk factors for tuberculosis in patients with CP.

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Material and Methods:

We performed a retrospective record analysis (8.3years average duration of CP) and a subsequent prospective follow-up (mean = 7.3years) of 136 CP patients from North-Western Romania operated in our clinic (1994-2003). To find risk factors for tuberculosis, we applied a Pearson product-moment correlation test, and multiple regression analysis for the following factors: age, sex, geographic distribution, profession, alcohol intake, cigarette smoking (number of cigarettes and years of smoking), CP duration, presence of calcifications, diabetes, steatorrhea, number of CP complications, BMI, and contact with infectious tuberculosis.

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Results:

During the follow-up period, 8 patients (5.88%) developed pulmonary tuberculosis. Six patients had severe forms (3 bilateral multiple cavities, 2 miliary form, and 1 pulmonary and peritoneal tuberculosis). Significant risk factors for tuberculosis (p < 0.005) were: high alcohol consumption, heavy smoking (more than 20 cigarettes/day), presence of diabetes, advanced CP (calcifications, steatorrhea, malnutrition with BMI<18), contact with infectious tuberculosis, and immunodepression.

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Conclusion:

Tuberculosis infection (mostly severe forms), have a higher incidence in patients with CP (especially in those with advanced disease) than in the general population. Prevention of tuberculosis implies quitting smoking and alcohol consumption, and better control of diabetes and steatorrhea. Follow-up of high risk CP patients must include a screening for tuberculosis.

© 2007 Lippincott Williams & Wilkins, Inc.