Serum iron and zinc changes in pulmonary tuberculosis patients during pharmacotherapy with regimens consisted of ethambutol

Mohammad Abbasinazari. Shahid Beheshti university of medical sciences, Clinical pharmacy, Iran

Introduction: Iron and zinc are essential trace elements that have important roles in physiological function of the human1,2. Ethambutol has a chelating effect owing to its chemical structure which is similar to that of penicillamine3. The aim of present study was to determine (1) whether ethambutol usage can alter serum iron and zinc levels in patients with tuberculosis and (2) whether there is any relationship between age and sex of patients with changes in serum iron and zinc levels.

Methods: Fifty patients with pulmonary tuberculosis were enrolled the study. Blood samples were given just before initiation of antituberculosis pharmacotherapy and after 10 days. Serum iron and zinc levels were determined in all samples by atomic absorption.

Results: Mean ± SD levels of iron at baseline and on the 10th day of ethambutol therapy were 54.05 ± 9.08 μg/dl and 34.09 ± 11.76 μg/dl , respectively. Mean ± SD concentration of zinc at baseline and on the 10th day of ethambutol therapy were 62.84 ± 18.40 μg/dl and 60.45 ± 19.40 μg/dl, respectively. Statistical analysis showed a significant reduction in iron level before and after treatment (p<0.0001). But there is not any significant change in zinc concentration before and after antituberculosis pharmacotherapy (p= 0.66). Also, there was not any relationship between changes in iron or zinc concentration and variables of age and sex.

Discussion: Our findings endorse the chelating effect of ethambutol leading to a decrease in serum iron but no change in zinc level.

Conclusion: Iron assessment in patients under treatment of ethambutol may be recommend.

Ref:

1. Fretham SJ, Carlson ES, Georgieff MK. The role of iron in learning and memory. Adv Nutr. 2011;2:112-21

2.Dardeenne M. Zinc and immune function. Eur J Clin Nutr 2002;56 Suppl 3: s20-3

3. Abbasi Nazari M, Kobarfard F, Tabarsi P, Salamzadeh J. Serum Copper (Cu) Alterations in Pulmonary Tuberculosis Patients Under treatment with Ethambutol. Biol Trace Elements Res 2009;128:161-166