Genexpert test and endometrial histological findings in infertile women

Garg, Roopakshi; Agarwal, Neelima; Gupta, Manisha

doi:10.18203/2320-1770.ijrcog20181339

Cited by 7 publications

(9 citation statements)

References 3 publications

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“…were not able to detect any patient positive with Gene Xpert among 81 infertile women suspected of having genital TB as a cause of infertility. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Role of Gene Xpert in the Detection of Genital Tuberculosis in Endometrial Tissue among Women with Infertility

Tiwari

Prasad²,

Tanwar

2020

J Hum Reprod Sci

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Objective: The objective of the study is to evaluate the clinical utility of Gene Xpert compared with other available diagnostic modalities in prompt diagnosis of female genital tuberculosis (TB) causing infertility. Material and Methods: This was a prospective, cross-sectional analytical study. Premenstrual endometrial biopsy specimens were collected from 176 infertile women of reproductive age group suspected of having genital TB. Samples were processed for acid-fast bacilli, culture, histopathology, polymerase chain reaction (PCR), and Gene Xpert. Patients detected positive on Gene Xpert and PCR were subjected to laparoscopy to look for affirmative findings of genital TB. The results were analyzed using composite gold standard consisting of patients positive with culture, histopathology, and laparoscopy. Results: A total of 18 patients were found positive using composite gold standard. Laparoscopy was positive in 15 patients, whereas culture and histopathology were positive in three and two patients, respectively. Gene Xpert was positive in two patients. None of them was detected with rifampicin resistance. The sensitivity of Gene Xpert was 11.11% whereas the specificity was 100%. Conclusion: Since genital TB is a paucibacillary disease, multiple diagnostic modalities are needed for diagnosis. Gene Xpert appears to be a useful modality in diagnosis of genital TB, owing to its high specificity, and can be recommended in conditions where microscopy, culture, and histopathology are negative; however, further randomized studies are required to support our hypothesis.

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“…were not able to detect any patient positive with Gene Xpert among 81 infertile women suspected of having genital TB as a cause of infertility. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Role of Gene Xpert in the Detection of Genital Tuberculosis in Endometrial Tissue among Women with Infertility

Tiwari

Prasad²,

Tanwar

2020

J Hum Reprod Sci

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“…In their study, among the 81 cases who presented with infertility 1 case (1.23%) was found positive for tubercular endometritis and the rest 80 cases (98.7%) had non tubercular findings suggestive of infertility. The study emphasized on sparse number of Mycobacterium tuberculosis in endometrial biopsy due to various reasons such as secondary nature of genital tuberculosis, limitation of infection to the fallopian tube and cyclical shedding of the endometrium making it evident that tuberculosis may not be detected in all cycles 3 . In another study conducted by Saxena et al, among 62 suspected cases of genital tuberculosis GeneXpert showed 1.6% positivity which was less compared to 22.9% positivity on culture.…”

Section: Discussionmentioning

confidence: 99%

“…Fallopian tube in females are most frequently affected (90-100%) followed by endometrium (50-60), ovaries (20-30), cervix (5-15%), vulva and vagina (1%) 2 . Infertility is a worldwide health problem, genital tuberculosis being one of its main causes accounting for nearly 18% infertility cases in India 3 .…”

mentioning

confidence: 99%

GeneXpert positivity and evaluation of rifampicin resistance among endometrial biopsy specimens for the diagnosis of Genital Tuberculosis

Kashyap¹,

Dibyashree²,

Saha³

et al. 2020

OBGYN

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Objective: The aim of this study was to find out the GeneXpert positivity among endometrial biopsy specimens for diagnosis of genital tuberculosis. Materials and Methods: A retrospective study was conducted from January 2019 to June 2019 on all women clinically and radiologically diagnosed with infertility, dyspareunia, menstrual irregularities and pelvic inflammatory disease. Endometrial biopsies were taken from all cases and subjected to GeneXpert test for detection of Mycobacterium tuberculosis. Result: Total number of suspected cases was 62 with age ranging from 19 years to 65 years. Majority of suspected cases were from the age group 21-30 years (54.8%). Five out of 62 (8%) cases tested positive for Mycobacterium tuberculosis by GeneXpert which were all sensitive to Rifampicin. Among these 5 cases, 2 were reported as medium positive and 3 as very low positive based on cycle threshold value. Conclusion: GeneXpert on endometrial biopsy may prove to be a reliable diagnostic modality for genital tuberculosis as well as multidrug resistance tuberculosis in females leading to timely management of the disease.

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“…In both positive cases for TB in CBNAAT, very low MTB was detected. Most previous studies detected TB on endometrial slides, but only a few have diagnosed FGTB on CBNAAT/Xpert [2][3][4]8]. Thangappah found that 6.9% of the endometrial samples were positive [7].…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory investigations, such as serology and microscopy, have little value in diagnosis, and culture takes a long time. Polymerase chain reaction (PCR) has high sensitivity but low specificity [ 4 ]. Histopathology of genital/endometrial tissue may detect tuberculosis (TB) by granulomatous lesions; however, it is not diagnostic because granulomas may also be found in other infectious diseases [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of the Cartridge-Based Nucleic Amplification (CBNAAT)/Xpert Test and Histology of Genital Tissues in Diagnosing Female Genital Tuberculosis

Kanti¹,

Seth²,

Gupta

et al. 2021

Cureus

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BackgroundDiagnosing female genital tuberculosis (FGTB) is very difficult by routine laboratory investigations. Collecting tissues from genital structures, especially from tubes for histology, is impossible. The cartridgebased nucleic amplification (CBNAAT)/Xpert RIF test is a new polymerase chain reaction (PCR)-based method that is quick and may diagnose FGTB from any tissue type; however, it should not be contaminated with blood. This study was conducted to compare the efficacy of CBNAAT and the histology of genital tissue in suspected cases. Materials and methodsThis was a prospective study of the diagnostic efficacy of 91 cases of suspected FGTB randomly selected from March 2018 to September 2019 at a rural tertiary care center. Endometrial tissue collected in 86 patients (59 infertility, 27 menstrual irregularities) and tubal/peritoneal tissue from hysterectomy or laparotomy specimens of five participants who underwent surgery were sent for histopathological analysis and CBNAAT and the results were evaluated and compared. ResultsThere were 59 (64.83%) and 32 (35.2%) cases of infertility and menstrual irregularities, respectively. Primary infertility (38; 41.75%) was the most common complaint. Endometrial biopsies (EB) of two (2.23%) cases were found positive for tuberculosis (TB) both on histopathological examination (HPE) and CBNAAT. In addition, both patients had primary infertility. Of the 32 cases with menstrual abnormalities (27 EB and three tubal tissue, two peritoneal and nodular tissue), none were found to be positive for TB on HPE or CBNAAT. A highly significant association was found between histopathology and CBNAAT (p<0.0001) in the endometrial tissue of infertile patients. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100% for CBNAAT, with reference to histopathology. ConclusionWe recommend CBNAAT for the early detection of FGTB, with the added advantage of early results, minimal technical expertise, and detection of drug-resistant tuberculosis (TB).

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Genexpert test and endometrial histological findings in infertile women

Cited by 7 publications

References 3 publications

Role of Gene Xpert in the Detection of Genital Tuberculosis in Endometrial Tissue among Women with Infertility

Role of Gene Xpert in the Detection of Genital Tuberculosis in Endometrial Tissue among Women with Infertility

GeneXpert positivity and evaluation of rifampicin resistance among endometrial biopsy specimens for the diagnosis of Genital Tuberculosis

Comparison of the Efficacy of the Cartridge-Based Nucleic Amplification (CBNAAT)/Xpert Test and Histology of Genital Tissues in Diagnosing Female Genital Tuberculosis

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