Serum Ceruloplasmin Albumin Ratio as A Marker of Treatment Response in Pulmonary Tuberculosis

BACKGROUND: The study was conducted to observe treatment response in pulmonary tuberculosis and to see diagnostic efficiency of ceruloplasmin and albumin ratio between pulmonary tuberculosis and multi drug resistant tuberculosis. MATERIALS AND METHODS: It was a longitudinal case control study. 50 diagnosed cases of pulmonary tuberculosis before starting treatment (group PTB-1) were followed after 2 months of treatment (group PTB-2). 50 diagnosed case of multi drug resistant tuberculosis (group MDR-TB). 50 age and sex matched healthy controls were taken and every candidate was examined for ceruloplasmin albumin ratio. RESULTS: Result (mean ± SD) of ceruloplasmin albumin ratio (mg of Ceruloplasmin/gm of Albumin) in the Control group was 5.23 ± 0.67, in PTB-1 was 9.32 ± 2.25, in the PTB-2 group was 7.46 ± 1.32 and in MDR TB group it was 9.365 ± 1.643. Hence it was seen that Ceruloplasmin albumin ratio was significantly higher in PTB-1 group compared to Control with p value <0.001. Ratio was lower in PTB-2 (2 months after treatment) compared to PTB-1 (before starting treatment) and it was statistically significant with p value <0.001. there was no significant difference in ratio was observed between PTB-1 and MDR TB group. CONCLUSION: It showed that the Ceruloplasmin albumin ratio increases after Tuberculosis and then it gradually comes down towards the normal level after treatment. Serum Ceruloplasmin albumin ratio (mg of Ceruloplasmin/gm of Albumin) can therefore be incorporated as a surrogate marker to assist in diagnosis as well as prognosis of pulmonary tuberculosis.