Diagnosis of Pleural Tuberculosis by Detection of Specific IgG Anti-Antigen 60 in Serum and Pleural Fluid

Caminero, José A.; Castro, Felipe Rodrı́guez de; Carrillo, Teresa; Diaz, F. Rivera; Bermejo, J. C. Rodriguez; Cabrera, P.

doi:10.1159/000196174

Cited by 15 publications

(6 citation statements)

References 10 publications

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“…For this reason, in addition to the clinical and radiological characteristics, the cytological and biochemical findings can aid in diagnosing tuberculous pleuritis. At present, several tests are of great interest for diagnosing tuberculous pleural effusion, such as ADA [3,4,5], interferon-γ [4, 17, 18], lysozyme [4, 19], the polymerase chain reaction [20, 21] or specific antibodies [22]. Lymphocytic predominance in pleural fluid is the rule in tuberculous effusions [2].…”

Section: Discussionmentioning

confidence: 99%

C-Reactive Protein in Lymphocytic Pleural Effusions: A Diagnostic Aid in Tuberculous Pleuritis

García-Pachón

Soler²,

Padilla-Navas³

et al. 2005

Respiration

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Background:C-reactive protein (CRP) pleural fluid levels have been found to be higher in tuberculosis and parapneumonic effusions than in other causes of pleural effusion. Objective:The aim of this study was to analyze whether CRP (a simple and inexpensive test) may be a diagnostic aid for tuberculosis in lymphocytic pleural effusions. Methods:One hundred and forty-four patients with a lymphocytic pleural effusion (more than 50% lymphocytes in the differential white blood cell count) were included. The patients were 93 men (65%) and 51 women (35%), aged 64 ± 18 years (mean ± SD). The diagnoses were as follows: tuberculosis, 20; pleural effusion associated with malignancy, 69; transudates, 38; other benign exudates, 17. Results: The CRP pleural fluid level was higher in tuberculous pleuritis (54 ± 24 mg/l) than in lymphocytic effusions of other origin (21 ± 16 mg/l; p < 0.001). High CRP levels (≧50 mg/l) have a high specificity for tuberculosis (95%), and low levels (<30 mg/l) have a high sensitivity (95%) for excluding disease. Conclusions: CRP pleural fluid level determination is useful in the diagnostic workup of lymphocytic pleural effusions. High CRP levels are very suggestive of tuberculous pleuritis, and low CRP levels make this diagnosis unlikely.

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Section: Discussionmentioning

confidence: 99%

C-Reactive Protein in Lymphocytic Pleural Effusions: A Diagnostic Aid in Tuberculous Pleuritis

García-Pachón

Soler²,

Padilla-Navas³

et al. 2005

Respiration

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“…[41][42][43][44][45][46][47] As seen in table 2 (and in online supplementary fig S1A available at http://thorax.bmj.com/supplemental), sensitivity estimates ranged from 0.26 to 1.00 and specificity estimates from 0.59 to 1.00. The specificity forest plot (online supplementary fig S1B available at http://thorax.bmj.com/ supplemental) includes 7 unique studies as 4 of the total 10 studies were conducted with the same comparison population.…”

Section: Description Of Included Studiesmentioning

confidence: 97%

“…[41][42][43][44][45][46][47][48][49] None of the studies reported the method (eg, consecutive or random) of subject selection. Only one study 48 ELISA was used in 20 studies and immunochromatography in one study.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis

Steingart

Henry

Laal

et al. 2007

Postgraduate Medical Journal

105

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Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic review was conducted to assess the accuracy of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. In a comprehensive search, 21 studies that reported data on sensitivity and specificity for extrapulmonary tuberculosis were identified. These studies evaluated seven different commercial tests, with Anda-TB IgG accounting for 48% of the studies. The results showed that (1) all commercial tests provided highly variable estimates of sensitivity (range 0.00-1.00) and specificity (range 0.59-1.00) for all extrapulmonary sites combined; (2) the Anda-TB IgG kit showed highly variable sensitivity (range 0.26-1.00) and specificity (range 0.59-1.00) for all extrapulmonary sites combined; (3) for all tests combined, sensitivity estimates for both lymph node tuberculosis (range 0.23-1.00) and pleural tuberculosis (range 0.26-0.59) were poor and inconsistent; and (4) there were no data to determine the accuracy of the tests in children or in patients with HIV infection, the two groups for which the test would be most useful. At present, commercial antibody detection tests for extrapulmonary tuberculosis have no role in clinical care or case detection.

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“…Immunoglobulin titers against mycobacterial antigens have also been proposed based on previous trials performed on patients with tuberculosis. 66,67 Mycobacterial antigen A60 obtained from M. bovis is found in all mycobacteria species, and immunoglobulin G (IgG) titers to this antigen could potentially help to detect affected individuals. In a small series, Oliver et al found significantly higher levels of IgG antibodies in both patients with positive acid-fast smears and cultures and patients with negative smears but positive cultures.…”

Section: Diagnostic Testingmentioning

confidence: 99%

Nontuberculous Mycobacteria in Patients with Cystic Fibrosis

Leung

Olivier

2013

Semin Respir Crit Care Med

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As a result of their underlying lung disease, patients with cystic fibrosis (CF) have a higher risk of developing nontuberculous mycobacteria (NTM) infections compared with the general population. Although NTM may be present intermittently in low amounts in the airways of CF patients without an apparent clinical effect, progressive respiratory decline due to NTM disease may also occur. Identifying this latter group of patients can be challenging for clinicians because the usual symptoms exhibited by infected individuals without CF may be difficult to distinguish from the baseline respiratory dysfunction of a patient with CF. The distinction, however, is of utmost importance because those patients with clinical worsening may benefit considerably from antimycobacterial treatment. For CF patients under evaluation for lung transplantation, NTM can play a critical role in determining overall outcomes, and treatment in the pre- and post-transplant period may be vital to success. A general approach to NTM in CF thus involves surveillance to detect NTM, careful monitoring for associated clinical decline, and consideration of treatment given for those with an otherwise unexplained deterioration. In this review, the epidemiology and clinical course of NTM in CF is described with an algorithm for management proposed.

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Diagnosis of Pleural Tuberculosis by Detection of Specific IgG Anti-Antigen 60 in Serum and Pleural Fluid

Cited by 15 publications

References 10 publications

C-Reactive Protein in Lymphocytic Pleural Effusions: A Diagnostic Aid in Tuberculous Pleuritis

C-Reactive Protein in Lymphocytic Pleural Effusions: A Diagnostic Aid in Tuberculous Pleuritis

A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis

Nontuberculous Mycobacteria in Patients with Cystic Fibrosis

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