Yield of Sputum Induction in the Diagnosis of Pleural Tuberculosis

Conde, Marcus Barreto; Loivos, Angela Chindamo; Rezende, Valeria M; Soares, Samira Silva Santos; Mello, Fernanda C. Q.; Reingold, Arthur; Daley, Charles L.; Kritski, Afrânio Lineu

doi:10.1164/rccm.2111019

Cited by 173 publications

(131 citation statements)

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“…In addition, the sensitivity of the test was 69%, which was greater than is that of culture for M. tuberculosis-the conventional test for the diagnosis of TB in PF-the reported sensitivity of which ranged from 10% to 20% in different case series. (3,15) Determination of immunoglobulin levels is relatively simple and inexpensive. Therefore, the determination of immunoglobulin levels in serum samples, PF samples, and other samples has long been investigated as a means of diagnosing TB.…”

Section: Discussionmentioning

confidence: 99%

Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural

et al. 2011

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Objective: To evaluate the accuracy of determining specific IgA to HspX recombinant antigen in pleural fluid and serum samples for the diagnosis of pleural tuberculosis in patients with pleural effusion. Methods: This was a cross-sectional study. Serum and pleural fluid samples of patients with pleural effusion and suspected of having pleural tuberculosis were tested with indirect ELISA in order to determine the optical density of specific IgA to HspX. Results: We evaluated serum and pleural fluid samples from 132 patients: 97 diagnosed with pleural tuberculosis (study group) and 35 diagnosed with pleural effusion due to other causes (control group). The determination of IgA in pleural fluid satisfactorily discriminated between pleural tuberculosis patients and control patients. The sensitivity of the test in pleural fluid and in serum was 69% and 30%, respectively, whereas the specificity was 83% and 84%, respectively. Conclusions: Our data suggest that this test can be used in the diagnosis of pleural tuberculosis. Further studies, involving larger patient samples and different epidemiological scenarios, are warranted.Keywords: Pleural effusion; Tuberculosis/diagnosis; Enzyme-linked immunosorbent assay. ResumoObjetivo: Avaliar a acurácia da dosagem de IgA contra o antígeno recombinante HspX no líquido pleural e no soro de pacientes com derrame pleural para o diagnóstico de tuberculose pleural. Métodos: Estudo transversal de teste diagnóstico. Amostras de líquido pleural e de soro de pacientes com derrame pleural e suspeita de tuberculose pleural foram avaliadas para a determinação da densidade óptica de IgA contra HspX utilizando ELISA indireto. Resultados: Foram avaliadas amostras de líquido pleural e de soro de 132 pacientes: 97 com tuberculose pleural (grupo de estudo) e 35 com derrame pleural por outras causas (grupo controle). A dosagem de IgA em líquido pleural foi capaz de discriminar os pacientes com tuberculose pleural dos controles. A sensibilidade do teste em líquido pleural e em soro foi, respectivamente, de 69% e 30%, enquanto a especificidade foi de 83% e 84%, respectivamente. Conclusões: Os dados sugerem o potencial da utilização deste teste no diagnóstico de tuberculose pleural. Estudos com amostras maiores e em diferentes cenários epidemiológicos são necessários.Descritores: Derrame pleural; Tuberculose/diagnóstico; ELISA. We sequentially included individuals who met the following inclusion criteria: being ≥ 12 years of age; presenting with free pleural fluid or pleural effusion, as demonstrated on lateral decubitus chest X-rays; and presenting with a Karnofsky performance status ≥ 60%. We excluded patients presenting with clinical or biochemical evidence of kidney, heart, or liver failure, those with a history of anticoagulant use or acetylsalicylic acid use in the 10 days preceding the procedure, those in whom the diagnosis was not confirmed, and those who did not complete all of the study procedures.All of the patients were submitted to the following: standardized interview; physica...

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Section: Discussionmentioning

confidence: 99%

Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural

et al. 2011

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“…The mean ADA were high in the 2 Indian studies done by Prasad R et al, and Gilhotra et al with the mean ADA level ranging between76.8 IU (±23.8) to 95.8 (±57.5). 41,42 In comparison to other studies: Burgess LJ, Baganha MF and Chopra RK. Values >45 IU/L is a sensitive method to differentiate tuberculous from non-tuberculous effusion.…”

Section: Glucosementioning

confidence: 94%

Profile of exudative pleural effusion in the region of Bhuj people

Desai

Arora²

2018

Int J Adv Med

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Background: Exudative pleural effusions are a common diagnostic problem in clinical practice, as the list of causes is quite exhaustive, although sometimes they can be inferred from the clinical picture. In the West the most common cause is Para pneumonic effusions followed by malignancy, while in India it is tubercular effusion followed by malignant effusion. Despite the availability of various tests, there is a need for deﬁning the best diagnostic and cost-effective approach to quickly diagnose and treat exudative pleural effusions. The objectives are to conduct a clinical and etiological study of exudative pleural effusion, to evaluate biochemical proﬁle, cytological proﬁle and radiological proﬁles of exudative pleural effusion.Methods: Prospective study of 100 patients with exudative pleural effusions. The demographic data was expressed as mean±standard deviation. Comparison between groups was done by Chi-Square test and Fischer exact test for categorical variables and Kruskar-Wallis and Mann-Whitney tests for continuous variables.Results: There were 67 males and 33 females. The mean age was 41.6±15.74. The majority were tubercular in origin (67%),13%,8%,3%and 6% were malignant effusions, Synpneumonic effusion, pancreatic effusions and empyema respectively. Diagnosis was not established in 3% of effusions. Massive effusions were seen in 53.8% of malignant effusions and 33.3% of empyemas. Most effusions had a total cell count between 1000 to 5000 cells /mm3.Lymphocyte predominant effusions were seen in 84.6% and 89.6% of malignant and tubercular effusions. 61.5% of malignant effusions had a positive cytology. Tubercular effusion had a pleural ﬂuid ADA more than 40 IU/L. 92.3% of malignant effusion had pleural ﬂuid ADA less than 30IU.Conclusions: Pleural effusion is a commonly encountered in medical practice and in our country, the commonest cause is tuberculosis, as is evidenced from the present study. The initial step in evaluating case of pleural effusion is to establish the cause of pleural effusion which is done by a detailed history, clinical examination and investigations like a chest radiology and pleural ﬂuid analysis. Even in the advanced diagnostic approaches, still detailed clinical history and examination of the patient of the patient is important to make a clinical diagnosis. All suspected cases of pleural effusion should undergo Sonography of the thorax along with routine chest x-ray. Fluid cytology should be done to conﬁrm tuberculosis or to rule out malignancy, which guides the physician for further evaluation of the patient if required.

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“…(13) A positividade da cultura em meio de Löwestein-Jensen varia de 10% a 35% para o líquido pleural e de 39% a 65% para o fragmento pleural obtido através de biópsia por agulha. (11) Em um estudo recente realizado no Brasil (2) foi demonstrado que os rendimentos da baciloscopia direta e da cultura para M. tuberculosis do escarro induzido de pacientes com derrame pleural por TB, mesmo na ausência de lesão no parênquima pulmonar radiologicamente visível, alcançaram 50%. Desta forma, em pacientes com derrame pleural e suspeita de etiologia tuberculosa, a realização do escarro induzido está indicada independentemente do aspecto da radiografia de tórax.…”

Section: Citologiaunclassified

“…A Tabela 1 mostra o rendimento dos diversos exames diagnósticos, incluindo bacteriologia e cultura, em 84 casos de TB pleural. (2) Lisozima É uma enzima bacteriolítica encontrada no soro e em líquidos de derrame, decorrente principalmente da decomposição dos leucócitos. Níveis elevados dessa enzima são encontrados no líquido pleural por tuberculose e nos empiemas.…”

Section: Citologiaunclassified

“…Em ambas a TB pleural está freqüentemente associada à forma pulmonar. (2) Nos países com alta prevalência, a TB ocorre mais em jovens como manifestação da TB primária, enquanto que nos países com baixa pre-valência ela atinje mais a população idosa, como conseqüência da reativação de um foco de infecção latente, caracterizando a reativação endógena da doença. (3)(4) EPIDEMIOLOGIA Em todo o mundo, cerca de nove milhões de pessoas desenvolvem TB a cada ano.…”

Section: Introductionunclassified

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Tuberculose pleural

2006

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INTRODUÇÃOO comprometimento pleural representa a forma mais freqüente da tuberculose (TB) extrapulmonar. Freqüências variáveis são observadas em diferentes países, de acordo com a prevalência da TB e da sorologia positiva para o vírus da imunodeficiência humana (HIV).(1)A TB pleural pode ser uma manifestação tanto da forma primária da doença (primo-infecção) quanto da reativação de uma infecção latente pelo Mycobacterium tuberculosis. Em ambas a TB pleural está freqüentemente associada à forma pulmonar.(2) Nos países com alta prevalência, a TB ocorre mais em jovens como manifestação da TB primária, enquanto que nos países com baixa pre- RESUMOO derrame pleural tuberculoso pode ser devido a uma manifestação da forma primária da doença ou da reativação de uma infecção latente pelo M. tuberculosis. Os avanços nos métodos laboratoriais contribuíram sobremaneira para um melhor diagnóstico e para a compreensão da fisiopatologia desta doença. No entanto, embora o derrame pleural predominante linfocítico seja indicativo de tuberculose em nosso meio, uma rotina de abordagem diagnóstica deve ser instituída a fim de orientar o tratamento precoce e evitar seqüelas.Descritores: Tuberculose pleural/fisiopatologia; Derrame pleural/fisiopatologia; Tuberculose pleural/epidemiologia; Derrame pleural/epidemiologia; Biopsia ABSTRACTTuberculous pleural effusion is a common manifestation of the primary form of the disease or consequence of the reactivation of a latent infection due to the M. tuberculosis. Advances in the laboratory methods have contributed to better diagnose and understand the pathophysiology of the effusion secondary to tuberculosis. However, although a predominant lymphocytic pleural effusion is suspicious of tuberculosis, a diagnostic routine shall be instituted to orient treatment and prevent undesirable sequels.Keywords: Tuberculosis, pleural/physiopathology; Pleural effusion/physiopathology; Tuberculosis, pleural/epidemiology; Pleural effusion/epidemiology; Biopsy valência ela atinje mais a população idosa, como conseqüência da reativação de um foco de infecção latente, caracterizando a reativação endógena da doença. EPIDEMIOLOGIAEm todo o mundo, cerca de nove milhões de pessoas desenvolvem TB a cada ano. Aproximadamente 80% delas vivem em 22 diferentes países, sendo que o Brasil ocupa o 15º lugar, com cerca de 80 mil casos notificados a cada ano. Em alguns estados, a incidência da doença supera 100 casos por 100 mil habitantes. Além disto, há uma estimativa de 50 milhões de pessoas infectadas.

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Yield of Sputum Induction in the Diagnosis of Pleural Tuberculosis

Cited by 173 publications

References 10 publications

Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural

Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural

Profile of exudative pleural effusion in the region of Bhuj people

Tuberculose pleural

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