Objective. To evaluate the efficacy of immunological tests for early detection of tuberculosis infection in children in the Yaroslavl Oblast (Russia).Material and methods. Medical records of 354 children and adolescents examined by ELISPOT (Enzyme-Linked ImmunoSpot) assay (T-SPOT.TB) in the Yaroslavl Oblast in 2020–2022 were studied. Four groups of children were distinguished: group 1 included children with active tuberculosis (n = 3); group 2 included children under 7 with altered tuberculin sensitivity (conversion of the tuberculin test) or children over 8 first-time tested positive for RTA, who were under the supervision of a phthisiatrician in the VI A group of dispensary registration (n = 52); group 3 included children with medical exemptions from screening immunodiagnostics (n = 49); and group 4 included children with refusals of their parents or legal representatives from skin tests (n = 250).Results. The sensitivity of both RTA and T-SPOT.TB tests achieved 100%, with the concordance level of 100%. When assessing discordant results (positive result for RTA and negative for T-SPOT.TB) in the VI A dispensary registration group, the majority of children were found to have an aggravated allergic anamnesis and somatic pathology. The maximum number of children examined by the laboratory method included those whose parents or legal representatives refused from skin test administration (70.6%).Conclusions. T-SPOT.TB is an optimal method for early detection of latent TB infection and TB in children at risk, including those with medical contraindications for skin tests or whose parents refused from screening immunodiagnostics.
The article presents a clinical case of a patient with mucopolysaccharidosis type I (MPS I), whose infectious status was aggravated by the course of disseminated BCG infection. Currently, there is no clear understanding of the role of the immune system in the polymorphism of clinical manifestations in patients with MPS, however, phagocytosis defects have been shown in single reports with MPS I. The high incidence of infectious complications in patients with MPS requires a deeper immunological examination in large groups of patients.
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