Tuberculose pulmonar: aumento da eficiência diagnóstica pela associação de métodos microbiológicos e imunológicos para pesquisa de anticorpos IgG anti - Mycobacterium tuberculosis por Western blotting e interferon-gama / Pulmonary tuberculosis: enhanced efficiency diagnostic combining microbiological and immunological methods to detect IgG anti Mycobacterium tuberculosis antibodies by Western blotting and interferon-gamma

AUTOR(ES)

Kelly Aparecida Kanunfre

DATA DE PUBLICAÇÃO

2007

RESUMO

Tuberculosis remains a major public-health problem. Rapid diagnosis and prompt treatment is the cornerstone to reduce morbidity, mortality and incidence of tuberculosis in the world. Alternative methods have been developed to overcome the limitations presented by conventional microbiological methods and to improve the diagnosis and prognosis of tuberculosis. In this study we verified the diagnostic performance of Western blotting for IgG anti-M.tuberculosis antibodies detection, QuantiFERON® - TB Gold and circulating adhesion molecules (ICAM-1 and Selectins) as prognosis markers. Thirty-one patients were followed-up during the treatment. Active pulmonary tuberculosis was diagnosed by clinical and laboratorial criteria. As group control healthy individuals, blood donors and patients with other lung diseases were included. Western blotting results showed a high performance with sensitivity of 94% and specificity of 96% for the diagnosis of pulmonary tuberculosis, attending WHO requirements for serological tests. After adjusting the threshold, QuantiFERON® - TB Gold showed sensitivity of 83% and specificity of 100%. The results of adhesion molecules suggested potential to use the test as prognosis markers. Combining Western blotting or QuantiFERON® - TB Gold with acid-fast bacilli (AFB) smear results, the overall sensitivity increase to more than 95%, and when combined with culture the overall sensitivity was 100%. Together, these findings, suggest that Western blotting could be a very useful supplementary tool for pulmonary tuberculosis, especially in patients with AFB smear negative.

ASSUNTO(S)

interferon type ii prognosis interferon tipo ii immunoglobulin g imunoglobulina g tuberculosis pulmonary/diagnosis western blotting western blotting tuberculose pulmonar/diagnóstico moléculas de adesão celular prognóstico cell adhesion molecules

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