Profiles of Erythrocytes, Thrombocytes, Leukocytes, Macrophages, and Interleukin-6 for Evaluating Molecular Rapid Test Results in Patients with Suspected Pulmonary Tuberculosis

Abstract

Pulmonary tuberculosis (TB) causes changes in hematologic profiles and increased proinflammatory cytokines. Molecular Rapid Testing (MRT) is the standard for TB diagnosis, but the access remains limited in some healthcare facilities. This systematic review aims to evaluate changes in hematological and immunological profiles in patients diagnosed with TB using RMT. A systematic review of the literature was conducted following the Preferred Reference Guidelines for Systematic Reviews and Meta-Analysis (PRISMA). A literature search was conducted on PubMed, ScienceDirect, and Google Scholar for publications from 2020–2025, using the keywords “Hematological Parameters in Tuberculosis,” “IL-6 in Tuberculosis,” “Hematological Parameters in Pulmonary TB,” and “IL-6 Tuberculosis Hematology GeneXpert”. The initial search identified 1,152 articles, which subsequently underwent a screening process based on the predefined inclusion and exclusion criteria. Included studies were clinical research articles written in English or Indonesian, measuring hematological parameters and/or IL-6 in pulmonary TB patients, available in full-text form, and having a Digital Object Identifier (DOI). A multi-step screening of titles, abstracts, and full-text articles was conducted, resulting in 15 articles for analysis through narrative synthesis. Most studies reported a consistent pattern of pulmonary TB causing anemia, leukocytosis with neutrophilia and lymphopenia, thrombocytosis, and an elevated Erythrocyte Sedimentation Rate (ESR) as signs of systemic inflammation. Nearly all studies reported a significant increase in IL-6 in active TB, which plays a role in fever, tissue inflammation, elevated hepcidin, and hematologic changes. The findings also indicate that macrophages, the primary target cells for TB infection, produce high levels of IL-6, triggering an inflammatory response reflected in hematological parameters. In conclusion, hematological parameters and IL-6 levels consistently exhibit changes in pulmonary TB and have potential as diagnostic biomarkers, particularly in healthcare settings with limited rapid diagnostic tools. Integrating hematological and IL-6 examinations with RMT may provide a more comprehensive understanding of inflammation and disease progression in patients with suspected pulmonary TB.

Keywords: Hematological parameters; Interleukin-6; macrophage response; pulmonary tuberculosis; rapid molecular testing