Sarcoidosis or Tuberculosis? Detecting Mycobacterium tuberculosis Complex DNA in Sarcoidosis Granulomas (original) (raw)
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The Clinical Respiratory Journal, 2011
Introduction: Increasing evidence indicates that mycobacteria may be involved in the aetiology and pathophysiology of sarcoidosis. Objectives: To investigate the association between Mycobacterium tuberculosis complex infection and sarcoidosis. Methods: Mediastinal lymph node biopsy specimens (formalin-fixed, paraffinembedded) from 52 Danish patients with sarcoidosis, 50 patients with mediastinal lymphadenopathy of other non-mycobacterial causes (negative controls) and 12 patients with histologically and/or culture-verified mycobacteriosis (positive controls) were included in the study. Biopsy samples were analysed for the presence of Mycobacterium tuberculosis complex by strand displacement assay and a subset of specimens were examined for bacterial rRNA by fluorescent in situ hybridisation using an eubacterial probe with general bacterial specificity (EUB338). Results: One patient with sarcoidosis displayed a positive M. tuberculosis complex test. All negative controls were negative in the test and 5/12 patients with mycobacteriosis were positive in the test. We detected M. tuberculosis complex DNA in 10-year-old biopsy samples. Thirty-six samples were tested with the eubacterial probe; of these, 67% were positive with no difference between patients and controls. Conclusion: Our results do not support the hypothesis that M. tuberculosis complex infection is involved in the pathogenesis of sarcoidosis. However, we stress the importance of excluding mycobacteriosis in the diagnostic workup of sarcoidosis patients.
Respiration, 2006
Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. The presence of mycobacterial nucleic acid components in patients with sarcoidosis has been demonstrated with varying degrees of success. Objectives: The aim of this study was to estimate the presence of Mycobacterium tuberculosis DNA in tissues from sarcoidosis patients, in Catalonia, Spain, as well as to assess the long-term clinical course in these patients. Methods: Fifty-eight paraffin-embedded tissue biopsies corresponding to cases of sarcoidosis (n = 23), lung neoplasm (n = 23), and lung tuberculosis (n = 12) available in 1996 were analyzed in a retrospective study by means of a nested polymerase chain reaction using primers corresponding to the insertion element IS6110 of M. tuberculosis complex. For greater sensitivity, Southern blot hybridization was performed. Clinical data were recorded prior to and after PCR analysis (follow-up reported until 2002). Results:M. tuberculosis DNA was present i...
Zhonghua bing li xue za zhi Chinese journal of pathology, 2006
To study the role of Mycobacterium tuberculosis in the pathogenesis of sarcoidosis. Archival material of 22 patients with a histologic diagnosis of sarcoidosis were retrieved. Real-time fluorescent polymerase chain reaction (PCR) was used to detect DNA fragments of the complex-specific insertion sequence IS6110 of Mycobacterium tuberculosis in formalin-fixed and paraffin-embedded biopsy samples. Among the 22 samples studied, Mycobacterium tuberculosis DNA was detected in 11 cases. The sequence of PCR amplified IS6110 DNA fragments completely matched with the related sequence in Mycobacterium tuberculosis gene. Mycobacterium tuberculosis DNA is identified in a certain proportion of patients with a clinicopathologic diagnosis of sarcoidosis. Mycobacterium tuberculosis may be an important etiologic agent, at least in some of these patients.
Journal of Clinical Microbiology, 2002
ABSTRACTThe cause(s) of sarcoidosis is unknown.Mycobacteriumspp. are suspected in Europe andPropionibacteriumspp. are suspected in Japan. The present international collaboration evaluated the possible etiological links between sarcoidosis and the suspected bacterial species. Formalin-fixed and paraffin-embedded sections of biopsy samples of lymph nodes, one from each of 108 patients with sarcoidosis and 65 patients with tuberculosis, together with 86 control samples, were collected from two institutes in Japan and three institutes in Italy, Germany, and England. Genomes ofPropionibacterium acnes,Propionibacterium granulosum,Mycobacterium tuberculosis,Mycobacterium aviumsubsp.paratuberculosis, andEscherichia coli(as the control) were counted by quantitative real-time PCR. EitherP. acnesorP. granulosumwas found in all but two of the sarcoid samples.M. aviumsubsp.paratuberculosiswas found in no sarcoid sample.M. tuberculosiswas found in 0 to 9% of the sarcoid samples but in 65 to 100% ...
Asymptomatic stage I sarcoidosis complicated by pulmonary tuberculosis: a case report
Journal of Medical Case Reports, 2008
Introduction: Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis and Nocardia species. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications for the patient. Case presentation: We present a case of a 67-year-old woman with undiagnosed asymptomatic stage I sarcoidosis for at least 8 years before her admission and a 1-month history of fever, exertional dyspnea and dry cough, in whom pulmonary tuberculosis was documented. Conclusion: This case highlights the need for great vigilance among physicians in order to rule out any possible infection before establishing the diagnosis of sarcoidosis.
Sarcoidosis is a multi-system granulomatous diseases of undetermined etiology characterized by activation of lymphocytes and mononuclear phagocytes at the site of the disease (I). Seen most often between 30-40 years of age, it can effect any race, though less common in tropics. It involves lungs in 80-90% of cases (2), although it is a multi-organ disease and can present to any of the medical or surgical discipline (3). In areas endemic for Tuberculosis like Pakistan there may be lot of difficulty in excluding Mycobacterial infection, since both the diseases have similar clinico-radiological, biochemical and pathological features (4). Clinical and epidemiological features favor the hypothesis that it results from environmental exposure. possibly infective agents. An updated review of the subject is presented.
Sarcoidosis and Tuberculosis: A Case Report and Literature Review
Journal of Exploratory Research in Pharmacology, 2021
Annex 2 Country profiles FOR 30 HIGH TB BURDEN COUNTRIES 20 high TB burden countries based on absolute number of incident cases 10 high TB burden countries based on severity of disease burden (incidence per capita) Data are as reported to WHO. Estimates of TB and MDR/RR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. b MDR is TB resistant to rifampicin and isoniazid; RR is TB resistant to rifampicin. c Calculated for pulmonary cases only. d Includes cases with unknown previous TB treatment history. e Includes patients diagnosed before 2018 and patients who were not laboratoryconfirmed. Data for all countries and years can be downloaded from www.who.int/tb/data Angola POPULATION 2018 31 MILLION ESTIMATES OF TB BURDEN, a 2018 NUMBER (thousands) RATE (per 100 000 population) Total TB incidence 109 (71-156) 355 (230-507) HIV-positive TB incidence 11 (6.8-15) 34 (22-49) MDR/RR-TB incidence b 3.9 (1.7-7.1) 13 (5.4-23) HIV-negative TB mortality 19 (11-28) 60 (36-91) HIV-positive TB mortality 3.7 (2.4-5.3) 12 (7.9-17) ESTIMATED PROPORTION OF TB CASES WITH MDR/RR-TB, 2018 New cases 2.4% (1.1-4.2) Previously treated cases 15% (11-19) Data for all countries and years can be downloaded from www.who.int/tb/data Bangladesh POPULATION 2018 161 MILLION ESTIMATES OF TB BURDEN, a 2018 NUMBER (thousands) RATE (per 100 000 population) Total TB incidence 357 (260-469) 221 (161-291) HIV-positive TB incidence 0.73 (0.36-1.2) 0.45 (0.23-0.76) MDR/RR-TB incidence b 5.9 (3.2-9.6) 3.7 (2-5.9) HIV-negative TB mortality 47 (30-67) 29 (18-42) HIV-positive TB mortality 0.19 (0.094-0.32) 0.12 (0.06-0.2) ESTIMATED PROPORTION OF TB CASES WITH MDR/RR-TB, 2018 New cases 1.5% (0.9-2.3) Previously treated cases 4.9% (3-7.9) Patients started on treatment d,e MDR/RR-TB: 1 147, XDR-TB: 6 MDR/RR-TB cases tested for resistance to second-line drugs 853 TREATMENT SUCCESS RATE AND COHORT SIZE SUCCESS COHORT New and relapse cases registered in 2017 94% 242 640 Previously treated cases, excluding relapse, registered in 2017 86% 1 561 HIV-positive TB cases registered in 2017 67% 89 MDR/RR-TB cases started on second-line treatment in 2016 78% 918 XDR-TB cases started on second-line treatment in 2016 63% 8 TB PREVENTIVE TREATMENT, 2018 % of HIV-positive people (newly enrolled in care) on preventive treatment % of children (aged <5) household contacts of bacteriologically confirmed TB cases on preventive treatment 43% (40-47)