RESUMO
Mannose-binding lectin (MBL) is a serum protein that activates the complement and mediates phagocytosis. MBL levels and MBL2 genotype may impact upon host susceptibility to tuberculosis (TB) disease but evidence to date has been conflicting. MBL2 exon 1 and promoter genotyping and serum MBL concentrations were determined in 79 patients with active tuberculosis (58 pulmonary TB and 21 extrapulmonary or miliary TB) and 120 household healthy contacts (HHC) from a Mediterranean area (Majorca Island, Spain). Significantly higher serum MBL levels were found in patients with active tuberculosis than in HHC [median MBL concentrations 3430 ng mL(-1) (10-28 415) and 2600 ng mL(-1) (5-20 000) respectively, P = 0.002]. These higher MBL levels were mainly related to the most prevalent YA/YA wild-type diplotype. There was a strong correlation between MBL2 exon 1 and promoter genotype and MBL levels. The diplotype LYQA/HYPA was present in 12 out of 57 of the pulmonary TB cases but in none of the extrapulmonary TB patients. Diplotype LXPA/HYPA, producer of high levels of MBL, was significantly more frequent in HHC than in patients (16.8% vs. 6.4%, P = 0.031) suggesting a protective role against the development of TB disease that has not been previously found.
Assuntos
Éxons/genética , Predisposição Genética para Doença/genética , Lectina de Ligação a Manose/genética , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas/genética , Tuberculose/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Frequência do Gene , Genótipo , Haplótipos , Humanos , Masculino , Lectina de Ligação a Manose/sangue , Ilhas do Mediterrâneo , Pessoa de Meia-Idade , Espanha , Tuberculose/sangue , Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/genética , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: Tuberculosis is an important health care problem, even in our setting. The objective of this study is to describe clinic and epidemiological features of cutaneous tuberculosis in our area. PATIENTS AND METHODS: A retrospective study was performed of all patients diagnosed of cutaneous tuberculosis in a hospital in Mallorca (Spain) from January 2003 to July 2011. The clinical forms, diagnostic methods used, treatment used and clinical course were recorded. RESULTS: Twenty-eight cases of cutaneous tuberculosis were diagnosed (5.9% of the tuberculosis cases diagnosed in this period), 15 with classic cutaneous tuberculosis (14 scrofuloderma, 1 empyema necessitatis) and 13 patients with tuberculids (8 erythema induratum of Bazin disease and 5 erythema nodosum). Scrofulodermas came from lymph nodes in 10 of the patients, infected bone in 4 and pleural in one case; 13/28 patients came from other continents. Most of the patients were treatment with 3-4 tuberculostatic drugs, with favorable course. CONCLUSIONS: Cutaneous tuberculosis is not uncommon in our setting. In classic cutaneous tuberculosis culture is the gold standard diagnostic method while tuberculids are most commonly diagnosed by histology.
Assuntos
Tuberculose Cutânea/epidemiologia , Adulto , Idoso , Antituberculosos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia , Resultado do Tratamento , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológicoRESUMO
With the objective of analyzing the usefulness of a new technique of fast detection of pneumococcal antigen in urine (Binax NOW Streptococcus pneumoniae urinary antigen test) 163 community pneumonia episodes were reviewed. The test was positive in 30 cases, and gave rise to therapeutic implications in 12 patients. The global sensitivity was 57%, being superior in patients with HIV infection (70%), and the specificity was 91.6%. In 16 episodes it was the only diagnostic test of pneumococcal infection. The determination of pneumococcal antigen through this technique is a useful tool for the diagnosis of community pneumonia, mainly due its high specificity.