Pulmonary tuberculosis may result from a complex of the phenomena predisposing to impaired blood coagulation. The purpose of the investigation was to study the efficiency of small-volume
plasmapheresis in the correction of
hemostatic disorders in patients with progressive destructive
pulmonary tuberculosis. The results of examination and treatment were analyzed in 112 patients aged 18 to 65 years who had progressive destructive
pulmonary tuberculosis treated at the Central Research Institute of
Tuberculosis, Russian Academy of Medical Sciences, in 1994 to 2004. The patients were divided into groups: Group 1 (basic)--43 subjects receiving the standard
therapy supplemented by 4 small-volume
plasmapheresis sessions every 2 days and comparison groups: 2A--36 patients receiving 2
plasmapheresis sessions at a week interval and 2B--33 patients being on the standard
therapy alone. In the presence of endogenous intoxication, the patients with disseminated and complicated fibrocavernous
tuberculosis were ascertained to develop blood coagulative disorders typical of grades 1-2 chronic
disseminated intravascular coagulation (
DIC). The use of small-volume
plasmapheresis in combination with antiaggregatory and
anticoagulant therapy in patients with disseminated and complicated fibrocavernous
pulmonary tuberculosis had a beneficial effect on the blood aggregation controlling system positive impact, prevented
DIC progression, promoted improvement of blood rheological properties. With the standard
therapy (including double
plasmapheresis at a week interval), positive
hemostatic changes were absent throughout the
preoperative period.