Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tuberculosis, Pleural”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed2001

Augmentation of apoptosis and interferon-gamma production at sites of active Mycobacterium tuberculosis infection in human tuberculosis.

Pleural tuberculosis (TB) was employed as a model to study T cell apoptosis at sites of active Mycobacterium tuberculosis (MTB) infection in human immunodeficiency virus (HIV)-coinfected (HIV/TB) patients and patients infected with TB alone. Apoptosis in blood and in pleural fluid mononuclear cells and cytokine immunoreactivities in plasma and in pleural fluid were evaluated. T cells were expanded at the site of MTB infection, irrespective of HIV status. Apoptosis of CD4 and non-CD4 T cells in the pleural space occurred in both HIV/TB and TB. Interferon (IFN)-gamma levels were increased in pleural fluid, compared with plasma. Spontaneous apoptosis correlated with specific loss of MTB-reactive, IFN-gamma-producing pleural T cells. Immunoreactivities of molecules potentially involved in apoptosis, such as tumor necrosis factor-alpha, Fas-ligand, and Fas, were increased in pleural fluid, compared with plasma. These data suggest that continued exposure of immunoreactive cells to MTB at sites of infection may initiate a vicious cycle in which immune activation and loss of antigen-responsive T cells occur concomitantly, thus favoring persistence of MTB infection.

AIDS-Related Opportunistic Infections↗
PubMed2000

[The significance of detecting tumor necrosis factor-alpha and its receptors in serum and pleural effusion in differentiating tuberculosis and malignant pleural effusions].

OBJECTIVE: To investigate the significance of TNF-alpha and its soluble receptors (sTNFR-I and sTNFR-II) in differentiating benign and malignant pleural disease. METHODS: TNF-alpha and its soluble receptors (sTNFR-I and sTNFR-II) were detected using ELISA method in the serum and pleural effusion of 25 cases of tuberculosis pleural effusion and 28 cases of malignant pleural effusion, and in the serum of 32 cases of normal control. RESULTS: TNF-alpha level in the serum of tuberculosis patients with pleural effusion is (16.4 +/- 6.2) ng/L, lower than that in the serum of malignant pleural effusion patients (20.5 +/- 10.9) ng/L (P < 0.01), but higher than that in the serum of normal control (11.0 +/- 2.9) ng/L (P < 0.01). TNF-alpha level in the pleural effusion of tuberculosis patients is (29.4 +/- 10.3) ng/L, significantly higher than that of malignant pleural effusion (11.7 +/- 2.0) ng/L (P < 0.01). The sTNFR-I and sTNFR-II level in the serum of malignant pleural effusion is (1,132 +/- 303) ng/L and (1,548 +/- 489) ng/L respectively, significantly higher than that in tuberculosis pleural effusion which is (979 +/- 146) ng/L and (977 +/- 93) ng/L (P < 0.01) respectively. The sTNFR-I and sTNFR-II level in malignant pleural effusion is (1,404 +/- 306) ng/L and (2,195 +/- 418) ng/L respectively, markedly higher than those in tuberculosis pleural effusion which is (1,185 +/- 215) ng/L and (1,195 +/- 300) ng/L (P < 0.01). CONCLUSION: There are highly elevated TNF-alpha in tuberculosis pleural effusion; The sTNFR-I and sTNFR-II level in the serum and pleural effusion of malignant pleural effusion patients are significantly higher than those in tuberculosis pleural effusion patients, suggesting they may play some role in differentiating benign and malignant pleural diseases.

Adult↗
PubMed2001

Evaluation of polymerase chain reaction for detection of Mycobacterium tuberculosis in pleural fluid.

OBJECTIVES: Tuberculosis, a reemergent killer, is threatening to assume serious proportions all over the world, particularly in view of the AIDS pandemic. The detection of mycobacterial DNA by polymerase chain reaction (PCR) in clinical samples is a promising approach for the rapid diagnosis of tuberculous infections. The aims of this study were to evaluate PCR for detection of Mycobacterium tuberculosis in pleural fluids and to correlate the results with adenosine deaminase activity (ADA) estimation and acid-fast bacilli (AFB) screening. METHODS: The sensitivity and specificity of PCR in detection of mycobacterial DNA in 20 samples of tuberculous pleural effusion were evaluated using 40 samples of nontubercular pleural effusion as controls. The results were correlated with the ADA in all 60 pleural fluids. In addition, AFB detection by Ziehl-Neelsen staining on cytospin smears of all pleural fluids was also compared. RESULTS: Of the 20 samples of tuberculous pleural effusion, mycobacterium could be detected by AFB staining in 4 samples. Fourteen samples were PCR positive. None of the samples from the control group were AFB or PCR positive. The sensitivity of PCR, therefore, was 70.0% with specificity of 100% (positive predictive value, 100%; negative predictive value, 86.95%). The sensitivity of AFB screening was at best 20%. The mean of ADA values in tubercular pleural effusions was 63.21 U/L (SD, 33.01), and the mean in the control samples was 51.1 U/L (SD, 29.71). Taking a cut-off value of 50 U/L, both the sensitivity and specificity of ADA estimation in diagnosing tuberculosis were only 55%. CONCLUSION: PCR represents a rapid and sensitive method for the detection of mycobacterial DNA in tuberculous pleural effusions. AFB screening has low sensitivity, and ADA estimation has both low sensitivity and specificity. Therefore, when the clinical suspicion is high and smear result is negative, but the signs and symptoms of M tuberculosis are apparent, PCR is the method of choice for identifying the infection.

Adenosine Deaminase↗
PubMed2000

Detection of mycobacterium tuberculosis in paraffin-embedded pleural biopsy specimens by commercial ribosomal RNA and DNA amplification kits.

STUDY OBJECTIVES: To evaluate the utility of two gene amplification systems in historical paraffin-embedded pleural biopsy (PEB) tissues from patients with pleural tuberculosis, and to compare the results to those obtained with conventional histologic and microbiological methods. DESIGN: A retrospective study. PATIENTS AND METHODS: Seventy-four formalin-fixed PEB tissues collected and stored over 12 years (1984 through 1995) were retrieved. Gene amplifications were performed in 57 tissues from patients with diagnoses of pleural tuberculosis and in 17 from patients with carcinoma as controls, using the first version of the Amplified Mycobacterium tuberculosis Direct Test (AMTDT; Gen-Probe; San Diego, CA) and the LCx Mycobacterium tuberculosis Assay (LCxMTB; Abbott Laboratories; Abbott Park, IL). RESULTS: The sensitivities of the AMTDT and LCxMTB were 52.6% and 63.2%, respectively (p = not statistically significant). The specificity of both tests was 100%. Twenty tissue samples (35.1%) were positive by both systems, and 10 tissues (17.5%) were positive only by the AMTDT, while 16 tissues (28.1%) were positive only by the LCxMTB. Both tests gave negative results for 11 specimens (19.3%). When both tests were used, a positive diagnosis was achieved in 80.7% of the samples. Diagnosis of 73.7% of patient conditions had previously been made by smear examination of pleural biopsy and sputum, pleural liquid, or biopsy culture. The overall diagnostic yield with both culture and amplification techniques was 96.5% (55 of 57 patients) for pleural tuberculosis, with amplification techniques adding 22.8% of the diagnoses. CONCLUSIONS: Amplification techniques are useful in archival PEB tissues, providing additional diagnoses beyond culturing, although the sensitivity should be improved, possibly by standardizing protocols.

Biopsy↗
PubMed1993

Pleural effusion, tuberculosis and HIV-1 infection in Kigali, Rwanda.

OBJECTIVE AND METHODS: An increasing number of diagnoses of pleural effusions (PE) have been made over the last 8 years in the Department of Internal Medicine of the Centre Hospitalier de Kigali, Rwanda. In order to determine the aetiology of PE and to examine its possible association with HIV-1 infection, we performed an aetiological work-up, including thoracocentesis and pleural punch biopsy, of all new patients with PE of undetermined aetiology referred to the Division of Pulmonary Diseases of the Department of Internal Medicine of the Centre Hospitalier de Kigali between 14 September 1988 and 16 October 1989. HIV-1 serological testing was performed for most of the patients. RESULTS: A total of 127 patients (81 men, 46 women; mean age, 34 years; range, 16-71 years) with PE of undetermined aetiology were enrolled. Pleural tuberculosis was diagnosed in 110 (86%) and confirmed histologically and/or bacteriologically in 90 (82%). Of 98 pleural tuberculosis patients tested for HIV-1-antibody, 82 (83%) were HIV-1-seropositive. Metastatic cancer was responsible for PE in six (5%) patients, Kaposi's sarcoma in three, lymphoma in one (all four HIV-1-seropositive), anaplastic carcinoma in one, and adenocarcinoma in one (both HIV-1-seronegative). Non-tuberculous pneumonia was documented in five (4%) patients and was associated with HIV-1 infection in four. Other causes of PE were congestive heart failure (three patients), decompensated cirrhosis (one), constrictive percarditis (one), or undetermined (one); only one of these patients was HIV-1-seropositive. CONCLUSIONS: We conclude that tuberculosis is the predominant cause of PE in our patients and is strongly associated with HIV-1 infection. Although less frequent, non-tuberculous pneumonia, Kaposi's sarcoma and lymphoma are other causes of HIV-1-associated PE. In an African area highly endemic for HIV-1 and Mycobacterium tuberculosis co-infection, PE should be considered a good marker of tuberculosis as well as HIV-1 infection.

AIDS-Related Opportunistic Infections↗
PubMed1994

Evaluation of three culture media and their combinations for the isolation of Mycobacterium tuberculosis from pleural aspirates of patients with tuberculous pleurisy.

The abilities of three culture systems to detect Mycobacterium tuberculosis from 480 pleural aspirate specimens in 347 patients were compared. The systems were the Bactec 12B radiometric detection system (Bactec 12B), the Middlebrook 7H9 broth (7H9), and two solid media including one pyruvate enriched Lowenstein-Jensen slope (LJP) and one non-selective Middlebrook 7H11 agar slope (7H11). In the 116 specimens obtained from 85 patients of confirmed pleural tuberculosis for the isolation of Mycobacterium tuberculosis, the diagnostic yields were 33 (39%) cases from Bactec 12B, 24 (28%) cases from 7H9 and 21 (25%) cases from LJP/7H11, with median detection times of 18, 47.5 and 44 days respectively. Thirteen isolates were recovered by the Bactec 12B only, 9 by the 7H9 broth only, and 2 by the LJP/7H11 agar only. The use of a combination of the three culture systems substantially increased the diagnostic yield to 47% over the individual systems. These results show that a significantly greater and faster diagnostic yield can be obtained by including Bactec 12B in pleural aspirate cultures for the recovery of Mycobacterium tuberculosis.

Biopsy, Needle↗
PubMed2002

Increased pleural fluid adenosine deaminase in brucellosis is difficult to differentiate from tuberculosis.

Pleural involvement in brucellosis is very rare. Current knowledge on brucella pleuritis is limited to a few case studies, and pleural adenosine deaminase (ADA) in brucellosis has not been studied previously. We report the pleural fluid characteristics, including ADA, of two cases with brucella pleurisy. Analysis of the pleural fluids revealed exudative effusions with increased ADA level, decreased glucose concentration, and lymphocyte predominance. The similarity with tuberculous pleurisy was remarkable. We suggest that brucellosis should be considered in the differential diagnosis of tuberculosis, especially in regions endemic for both diseases.

Adenosine Deaminase↗
PubMed1979

[Thoracoscopy in chronic pleural effusion (author's transl)].

123 patients with chronic pleurisy were investigated by thoracoscopy. The endoscopic biopsy is positive in 16 out of 17 cases of mesothelioma (96%), in 57 out of 72 cases of pleural metastasis (79%), and in 6 cases out of 7 pleural tuberculosis. Begnin pleural asbestosis was confirmed in 5. Endoscopic biopsy is thus more efficient than results obtained with pleural needle biopsy and exudative cytology. Thoracoscopy can be performed without any serious complications, this is not always true with open thoracotomy.

Anesthesia, General↗
PubMed1987

Short-course antituberculous chemotherapy for pulmonary and pleural disease: 5 years' experience in clinical practice.

One hundred and twenty-four patients have been treated with 6-month regimens for pulmonary and pleural tuberculosis over 5 years; 118 patients have completed treatment as planned. No patient has relapsed of the 109 followed up for 15 months from the end of chemotherapy, or in the remaining nine patients still under observation. Significant drug side effects requiring alteration of treatment occurred in only three patients. Six-month regimens in routine practice are well tolerated and are highly effective.

Adolescent↗
PubMed2004

[A study on the Th1/Th2 cytokines in the pathogenesis of human tuberculous pleuritis].

OBJECTIVE: To evaluate the distribution characteristics of Th1-type cytokines (IFN-gamma and IL-2) and Th2-type cytokines (IL-4 and IL-10) in the serum and the pleural effusion in patients with pleural tuberculosis, therefore to gain insight into the possible role of the local and the systemic Th1/Th2 cell-mediated immune response in the pathogenesis of human pleural tuberculosis. METHODS: The concentrations of IFN-gamma, IL-2, IL-4, and IL-10 in the serum and the pleural effusion of patients with pleural tuberculosis (Group pleuritis) were measured with enzyme linked immuno-sorbent assay (ELISA). The serum levels of the four cytokines were compared with those of patients with pulmonary tuberculosis (Group tuberculosis) and of healthy controls with positive reaction to PPD skin test (Group healthy). RESULTS: (1) The median concentrations of IFN-gamma, IL-2, IL-4, and IL-10 in serum were 118.60 ng/L, 0.00 ng/L, 1.49 ng/L, and 0.00 ng/L respectively in Group pleuritis, 265.75 ng/L, 18.03 ng/L, 16.00 ng/L, and 0.00 ng/L respectively in Group tuberculosis; and 221.70 ng/L, 18.52 ng/L, 16.00 ng/L, and 0.00 ng/L respectively in Group healthy. (2) For IFN-gamma and IL-2, there existed no statistical differences among the three groups (K-W chi(2) value was 1.15 and 4.68, P > 0.05); For IL-4 and IL-10, there existed no statistical differences between Group tuberculosis and Group healthy (Mann-Whitney Z value was -0.27 and -1.93, P > 0.05), but the level of IL-4 in Group pleuritis was lower than that in Group tuberculosis (Mann-Whitney Z value was -2.84, P < 0.01). (3) The ratio of the median of IFN-gamma to IL-4 in serum was 27.93 in Group pleuritis, 21.72 in Group tuberculosis, and 10.82 in Group healthy respectively. There existed no statistical difference among the three groups (K-W chi(2) value was 4.18, P > 0.05). (4) The median concentrations of IFN-gamma, IL-2, IL-4, and IL-10 in pleural effusion of Group pleuritis were 823.37 ng/L, 43.76 ng/L, 26 ng/L and 38.69 ng/L respectively, each being statistically higher than that in the serum (Wilcoxon Signed Rank test Z value was -4.34, -2.82, -3.29 and -5.15, P < 0.05). CONCLUSIONS: Immunocompetent persons including patients with pleural tuberculosis, with pulmonary tuberculosis or the healthy with positive results to PPD test, showed similar systemic Th1 response to Mycobacterium bacilli. Due to the relatively lower level of systemic Th2 response, patients with pleural tuberculosis had higher systemic Th1/Th2 level and the enhancement of local Th1 and Th2 responses in the pleural cavity was a pathophysiologic characteristic of human pleural tuberculosis. Both Th1 and Th2 responses might play an important role in the pathogenesis of human pleural tuberculosis.

Adolescent↗
PubMed1991

Ultrasound-guided pleural biopsy with Tru-Cut needle.

We conducted a study of ultrasound (US)-guided pleural biopsy with a Tru-Cut needle and made a comparison with the results of a traditional pleural biopsy with an Abrams needle. A total of 49 patients with unilateral pleural effusion were included in this study. Twenty-four patients underwent a traditional pleural biopsy with an Abrams needle, and 25 patients underwent a US-guided pleural biopsy with a Tru-Cut needle. The age, sex, and underlying diseases in both groups were compatible. The amount of effusion was much less in the Tru-Cut group. In the patients who underwent the US-guided pleural biopsy with a Tru-Cut needle, the diagnostic sensitivity in pleural tuberculosis was 86 percent (6/7) and in pleural neoplasia it was 70 percent (7/10). In the patients who underwent traditional pleural biopsy with an Abrams needle, the diagnostic sensitivity in pleural tuberculosis was 20 percent (2/10) and in pleural neoplasia it was 44 percent (4/9). The result of US-guided pleural biopsy with a Tru-Cut needle was better than that of pleural biopsy with an Abrams needle, especially in pleural tuberculosis. No complication was found in the Tru-Cut group, but breakage and dislodgment of the tip of an Abrams needle occurred in one patient. The higher diagnostic yield in the Tru-Cut group may be attributed to the US guidance that can delineate the focal pleural abnormalities for biopsy. In conclusion, US-guided pleural biopsy by using a Tru-Cut needle was simple, safe, and well tolerated. It was particularly useful for patients with pleural tumor, thickened pleura, small amounts of pleural effusion, or loculated pleural effusion.

Adult↗