Diagnostic role of Mantoux test site biopsy in neurosarcoidosis

Mankodi, Ami; Desai, Anil D.; Mathur, Rajiv S.; Poncha, Fali F.

doi:10.1212/wnl.51.4.1216

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…Other causes for this reaction at the Mantoux site could include a sarcoidal reaction at the injection site or a tuberculoid granuloma due to active tuberculosis. Typical sarcoidal granulomas have been reported at the Mantoux site in patients with sarcoidosis, and it has been proposed that this be used as a screening test for this disease 4 . The histopathology in our case clearly excludes this possibility, as there was a complete absence of sarcoidal or tuberculoid granulomas in the specimen.…”

Section: Discussionsupporting

confidence: 52%

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Foreign body reaction involving a Mantoux test site

2005

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A 41-year-old woman presented with a history of a solitary pustular erythematous lesion occurring at the site of a Mantoux test performed 10 months previously. The histopathology examination revealed a suppurative and foreign body giant cell reaction to numerous keratin flakes. Culture of the tissue was negative for both aerobic and anaerobic organisms including mycobacteria. We postulate that the reaction in our patient may have been secondary to the implantation of epidermal keratin or the entrapment of hair into the dermis during the intradermal injection of tuberculin purified protein derivative.

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Section: Discussionsupporting

confidence: 52%

“…These changes peak 48–72 hours after the injection and usually subside over 2 weeks. Mantoux test reaction is not a foreign body type response 4 …”

Section: Discussionmentioning

confidence: 99%

Foreign body reaction involving a Mantoux test site

2005

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“…4 Historically, the injection of antigen prepared from the liver or spleen of patients with sarcoidosis (the Kveim test) has been used for diagnosis but it is not well-standardized, nor commercially available. 6,14 More recently, the Mantoux test site biopsy has been proposed as an alternative. 14 A standard forearm skin Mantoux test is done and is typically negative, but skin biopsy of the site at a later date may reveal noncaseating granulomas.…”

Section: Discussionmentioning

confidence: 99%

The Role of MRI and Nerve Root Biopsy in the Diagnosis of Neurosarcoidosis

Moore

Andermann

Richardson

et al. 2001

Can. j. neurol. sci.

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Objectives:Neurological involvement occurs in 5-15% of patients with sarcoidosis and isolated “neurosarcoidosis” occurs in less than 1% of all cases. Classical clinical presentations have been described, such as bilateral facial palsy, but often the disease presents insidiously with varied signs and symptoms. We present a patient who required biopsy of a lumbar nerve root for diagnosis of chronic, progressive neurosarcoidosis and review the literature with an emphasis on diagnosis.Methods:We have reviewed a patient who presented with signs and symptoms related to infiltration of her meninges and nerve roots by sarcoidosis. All pertinent history and physical information was taken from interviews with the patient and review of her chart. Laboratory, radiographic, and pathological investigations are presented.Results and conclusions:A high index of suspicion is required for the diagnosis of neurosarcoidosis. Gadolinium-enhanced MRI is useful but the findings are often nonspecific, and there should be a low threshold for biopsy whenever the diagnosis is considered.

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“…[ 2 ] On the other hand, delayed development (usually after 4 to 6 weeks) of sarcoidal granulomas at TST sites has previously been reported in established pulmonary and neurosarcoidosis. [ 3 ] Although the exact prevalence of such a response varies (possibly depending on the site involved and severity), these delayed “reactions” are not reproducible with other skin antigens in control testing. [ 4 ] Whether this represents a specific immune response to the purified protein derivative or reflects the pathogenic role of mycobacterial antigens in the development of sarcoidosis remains unclear.…”

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confidence: 99%