Evaluation of polymerase chain reaction for rapid diagnosis of clinically suspected tuberculous pleurisy |
| |
| Authors: | Dil-Afroze Dinesh Sharma G N Dhobi Sonaullah Shah Rafiqa Eachkoti Ishraq Hussain Zafar A Shah Mushtaq A Siddiqi |
| |
| Institution: | (1) Department of Medicine, Sher-I-Kashmir Institute of Medical Sciences, J&K-190011 Soura, India;(2) Department of Immunology & Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, J&K-190011 Soura, India |
| |
| Abstract: | Pleural effusion is one of the commonest presentations of tuberculosis, the clinical manifestations being typically abrupt
resembling bacterial pneumonia. Since delayed hypersensitivity is the underlying immune response, bacterial load is very low.
Owing to these facts, tuberculous pleurisy as an extra-pulmonary disease poses a diagnostic dilemma. The conventional bacteriological
methods rarely detect Mycobacterium tuberculosis in pleural fluid and are of limited use in diagnosis of tuberculous pleurisy.
We evaluated the efficacy of polymerase chain reaction (PCR) in the diagnosis of tuberculous pleurisy by targeting the gene
segment coding for MPB64 protein specific forMycobacterium tuberculosis. Based on the clinical criteria, 82 patients with lymphocytic exudative pleural effusion were included in the study. Patients
were analyzed in two groups; one group consisting of 48 patients of tubercular pleural effusion confimed by various diagnostic
procedures and another group of 34 patients comprising of non-tubercular pleural effusion. There were no false positive results
by PCR and the specificity worked out to be 100%. Twenty two patients tested positive for Mantoux with a sensitivity of 45%.
ZN-staining for AFB was found in samples from 15 patients (20% sensitivity). ADA was positive for 28 patients with a sensitivity
of 53%. PCR was positive for 32/48 patients (67% sensitivity). Thus, PCR was found to be more sensitive than any other conventional
method in diagnosis of clinically suspected tubercular pleurisy. |
| |
| Keywords: | Polymerase chain reaction Mycobacterium tuberculosis MPB64 tubercular pleurisy |
| 本文献已被 SpringerLink 等数据库收录！ |
|
