[Show abstract][Hide abstract] ABSTRACT: Immunoglobulin G (IgG) and IgM antibodies against the SL-IV antigen of Mycobacterium tuberculosis in the sera of patients with tuberculosis with negative serology for human immunodeficiency virus (HIV) infection (TB group; n = 97), patients with tuberculosis with positive serology for HIV infection (TB-HIV group; n = 59), and healthy controls (n = 289) were determined by enzyme-linked immunosorbent assay. All sera were obtained at the onset of tuberculosis, i.e., when clinical symptoms appeared. Clinical specimens were collected and cultured for the isolation of M. tuberculosis, and treatment with antituberculous drugs was started. Sera were also obtained from patients in the TB group at fixed intervals during treatment; sera were available from 13 patients in the TB-HIV group before the onset of tuberculosis. The best specificity and positive predictive values were obtained with the IgG assays. In the IgG assays at specificities above 96.0%, the sensitivities of the tests were 45.3 and 72.8% for the TB and TB-HIV groups, respectively, and the sensitivity was 51.9% when data from both groups were combined for analysis. For the TB group, results of this study indicated that the levels of IgG antibodies remain high during treatment. Thus, repetitive serological assays may not be useful for treatment follow-up. In the TB-HIV group, 12 of 13 patients had IgG-specific antibodies against the SL-IV antigen between 1 and 30 months before the onset of tuberculosis, so we suggest that the IgG antibody assay against SL-IV may be helpful for identifying tuberculosis in patients infected with HIV.
Journal of Clinical Microbiology 06/1992; 30(5):1089-93. · 4.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Differences in tuberculosis diagnosis between infected and non-infected HIV patients were described. In Barcelona, tuberculosis is present in 41.6% of 851 patients in whom AIDS was detected between 1981 and the first quarter of 1990. We reviewed the results of the methods used for tuberculosis diagnosis in 270 AIDS patients controlled in our hospital, in whom tuberculosis was detected (33.3%), and we compared these data with the results obtained in HIV carriers with tuberculosis and with tuberculous patients without HIV infection. Statistically significant differences were found between the three groups with respect to sex, age, results of Ziehl-Neelsen stain in pulmonary specimens and skin test reaction; between AIDS patients and the non-HIV infected population differences were observed in tuberculosis site. Positive skin test reaction diminished from tuberculous individuals non-HIV infected (95%), to HIV carriers with tuberculosis (71.8%) and AIDS patients with tuberculosis (21.8%). Acid-fast smears from pulmonary specimens were positive in 35.7%, 23.5% and 43.7% respectively. Statistically significant differences were found in tuberculosis localization between tuberculous patients non-HIV infected and tuberculous patients with AIDS, in the last group tuberculosis lymphadenitis was the most frequent localization (33.3%) of extrapulmonary tuberculosis, followed by abdominal tuberculosis (15.5%). The incidence of HIV infection among tuberculous patients was 4.6 in our study, but could be higher if patients between 19 and 30 years old were always checked for anti-HIV antibodies.
Journal of hygiene, epidemiology, microbiology, and immunology 02/1992; 36(3):293-302.
[Show abstract][Hide abstract] ABSTRACT: The isolation of mycobacteria in abdominal specimens during a 10 years period is presented. Twenty-three clinical cases have been reviewed; patients were divided in three groups: 1) Peritoneal and intestinal tuberculosis. 2) Pulmonary tuberculosis with isolation of M. tuberculosis in feces, and 3) Miliary tuberculosis. We emphasize the low yielding of bacilloscopy, the low number of colonies in cultures and the importance of the microbiological study of abdominal specimens in the confirmatory diagnosis. The predominant symptoms of peritoneal tuberculosis were abdominal pain and distention and fever. The study of the ascitic fluid showed in most of the cases lymphocytic exudate and the pathological study of biopsies showed granulomas with caseous necrosis. Three patients had another associated abdominal disease. Isolation of M. tuberculosis in feces does not invariably mean the presence of intestinal tuberculosis. We confirm the frequent association of disseminated tuberculosis and HIV1 infection.
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 07/1990; 77(6):409-13. · 1.32 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sera from 38 tuberculous patients and 62 healthy controls (31 PPD skin test positive and 31 negative) were assayed, by enzyme-linked immunosorbent assay (ELISA), to test the activity of IgG and IgM antibodies against purified protein derivative (PPD) antigen and a phenolglycolipid antigen (PLG-Tb 1) isolated and purified from Mycobacterium tuberculosis strain Canetti. Using PPD antigen, the sensitivity and specificity were respectively, 50 and 93.5% for IgG and 71.1 and 59.7% for IgM antibody activity. Against PGL-Tb 1 antigen, IgG had a sensitivity of 94.7% and the specificity was 96.8%, for IgM antibody they were 65.8% and 75.8% respectively. The ELISA using PGL-Tb 1 antigen could be a useful way to develop a rapid technique to aid in the diagnosis of tuberculosis.
[Show abstract][Hide abstract] ABSTRACT: Four patients with malignant melanoma (MM) and associated solitary pulmonary nodules (SPN) are described, three had endobronchial metastasis and one primary bronchial neoplasm. The pertinent literature is reviewed for the incidence and origen of SPN which appear with extra thoracic neoplasm in general and malignant melanoma in particular.
The importance of following-up all patients which MM for early detection of pulmonary metastasis, which may be the only manifestation in 50% of all pulmonary metastasis, is emphasized. The diagnostic methods of choice are discussed.
Archivos de Bronconeumología 05/1983; 19(3):128-131. · 2.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: From a series of 110 patients with sarcoidosis seen at our hospital from October 1971 to September 1979, five cases were found with histologically proven pleural sarcoidosis, an incidence of 4.6%. Pleural involvement was not described in the surgical or autopsy protocols. Infiltration by sarcoid granulomas was found in the visceral and/or parietal layers in five cases of seven in whom pleural tissue was available for examination. The layer affected depended directly on the available sample. Only one patient had pleural effusion, which was an exudate with a high lymphocyte count; the case corresponded to a stage II sarcoidosis. The number of histologically proven cases of pleural sarcoidosis reported in the medical literature is very small, only 52 cass, including our own. In conclusion, it appears that the frequency of pleural sarcoidosis is falsely low, and that the availability of pleural tissue in patients with sarcoidosis undergoing thoracotomy might rise the figures heretofore encountered.