Restricted accessOtherFirst published online 2009-02
Mycobacterium tuberculosis-specific immunospot assay of pleural exudate mononuclear cells is useful for the exclusion of tuberculous pleuritis in patients with lupus pleuritis
It is often difficult to make a diagnosis of pleuritis associated with rheumatic diseases because of lack of specific diagnostic tools. We report a patient with lupus pleuritis from which tuberculous pleuritis was distinguished by Mycobacterium tuberculosis-specific enzyme-linked immunospot assay of pleural exudate mononuclear cells. After the diagnosis of lupus pleuritis, the patient was successfully treated with prednisolone.
1 Gopi A Madhavan SM Sharma SK Sahn SA . Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest2007; 131: 880–889.
2.
2 Porcel JM Ordi-Ros J Esquerda A . Antinuclear antibody testing in pleural fluid for the diagnosis of lupus pleuritis. Lupus2007; 16: 25–27.
3.
3 van Leeuwen RM Bossink AW Thijsen SF . Exclusion of active Mycobacterium tuberculosis complex infection with the T-SPOT.TB assay. Eur Respir J2007; 29: 605–607.
4.
4 Menzies D Pai M Comstock G . Meta-analysis. new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med2007; 146: 340–354.
5.
5 Richeldi L Luppi M Losi M . Diagnosis of occult tuberculosis in hematological malignancy by enumeration of antigen-specific T cells. Leukemia2006; 20: 379–381.
6.
6 Ferrara G Losi M D'Amico R . Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: a prospective study. Lancet2006; 367: 1328–1334.
7.
7 Lange C Hellmich B Ernst M Ehlers S . Rapid immunodiagnosis of tuberculosis in a woman receiving anti-TNF therapy. Nat Clin Pract Rheumatol2007; 3: 528–534.
8.
8 Losi M Bossink A Codecasa L . Use of a T-cell interferon-gamma release assay for the diagnosis of tuberculous pleurisy. Eur Respir J2007; 30: 1173–1179.
9.
9 Ariga H Kawabe Y Nagai H . Diagnosis of active Tuberculous Serositis by Antigen-Specific Interferon-gamma Response of Cavity Fluid Cells. Clin Infect Dis2007; 45: 1559–1567.
10.
10 Gardam MA Keystone EC Menzies R . Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management. Lancet Infect Dis2003; 3: 148–155.
