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Jozélio Freire De Carvalho - One of the best experts on this subject based on the ideXlab platform.
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Erythema induratum of Bazin associated with Addison's disease: first description
Sao Paulo medical journal = Revista paulista de medicina, 2012Co-Authors: Rodrigo Antonio Brandão Neto, Jozélio Freire De CarvalhoAbstract:CONTEXT: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive Tuberculin test and positive BCG (bacillus Calmette-Guerin) test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.
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Erythema induratum of Bazin associated with Addison's disease: first description
Associação Paulista de Medicina - APM, 2012Co-Authors: Brandão Neto,rodrigo Antonio, Jozélio Freire De CarvalhoAbstract:CONTEXT: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive Tuberculin test and positive BCG (bacillus Calmette-Guérin) test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease
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Erythema induratum of Bazin associated with Addison's disease: first description Eritema indurado de Bazin associado à doença de Addison: primeira descrição
Associação Paulista de Medicina, 2012Co-Authors: Rodrigo Antonio Brandão Neto, Jozélio Freire De CarvalhoAbstract:CONTEXT: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive Tuberculin test and positive BCG (bacillus Calmette-Guérin) test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.CONTEXTO: O eritema indurado de Bazin (EIB) é considerado uma reação tuberculoide e consiste de nódulos dolorosos recorrentes. O diagnóstico diferencial inclui doenças como vasculite nodular, perniose, poliarterite nodosa e eritema nodoso. RELATO DE CASO: Nós reportamos o caso de uma mulher com EIB que desenvolveu doença de Addison durante tratamento com drogas tuberculostáticas e com boa resposta com reposição de glicocorticoide. O diagnóstico foi realizado pela apresentação clínica, teste tuberculínico positivo e positividade para BCG (bacilo Calmette-Guérin) no espécime histológico. A reposição de glicocorticoides e drogas tuberculostáticas levou ao desaparecimento dos sinais e sintomas. CONCLUSÕES: Este é o primeiro caso reportando a associação entre EIB e doença de Addison. Tuberculose é um importante agente etiológico da doença de Addison
Dick Menzies - One of the best experts on this subject based on the ideXlab platform.
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what does Tuberculin reactivity after bacille calmette guerin vaccination tell us
Clinical Infectious Diseases, 2000Co-Authors: Dick MenziesAbstract:The effect of bacille Calmette-Guerin (BCG) vaccination on Tuberculin reactivity is briefly reviewed. BCG vaccination will almost invariably result in Tuberculin conversion with a positive Tuberculin skin test developing 4-8 weeks after vaccination. However, these Tuberculin reactions will wane-rapidly in all individuals who receive the vaccine in the neonatal period and more slowly in those who are vaccinated at an older age such as during the primary-school years. Of BCG vaccine recipients whose initial Tuberculin skin test is negative, 10%-25% will have a positive Tuberculin skin test if they are retested within 1-4 weeks-the so-called "booster phenomenon. " There is no relationship between Tuberculin reactivity after BCG vaccination and the protective efficacy of the vaccine against development of active tuberculosis. Therefore, the ideal BCG vaccine would produce a scar at the site of injection to identify individuals who have been vaccinated but would have no effect on Tuberculin reactivity.
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Interpretation of repeated Tuberculin tests. Boosting, conversion, and reversion.
American journal of respiratory and critical care medicine, 1999Co-Authors: Dick MenziesAbstract:The Tuberculin skin test is one of the few tests developed in the 19th century that is still in present use in clinical medicine. The first Tuberculin test material was prepared by Robert Koch (1); its use for detection of tuberculosis (TB) infection was first described in 1907 by von Pirquet (2). Given such a long history of use, it may seem surprising that aspects of interpretation of this test remain controversial. However, this reflects changes in the populations affected with tuberculosis and their relative frequency of true positive tests from TB infection, and false-positive tests associated with bacillus Calmette-Guerin (BCG) vaccination, or nontuberculous mycobacteria, as well as the recent human immunodeficiency virus (HIV) epidemic. Particular problems have arisen with use of repeated Tuberculin tests to detect new infection in high-risk populations such as initially Tuberculin-negative contacts of active cases, and workers with occupational exposure. This has revealed that Tuberculin reactions may decrease in size (reversion) or increase in size because of: ( 1 ) random variability from differences in administration, reading, or biologic response; ( 2 ) immunologic recall of preexisting delayed type hypersensitivity to mycobacterial antigens (boosting); or ( 3 ) new infection (conversion). This review has been undertaken to provide information regarding factors causing changes in the size of repeated Tuberculin reactions.
Deborah Cohan - One of the best experts on this subject based on the ideXlab platform.
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interferon gamma release assay compared with the Tuberculin skin test for latent tuberculosis detection in pregnancy
Obstetrics & Gynecology, 2011Co-Authors: Ayaba Worjoloh, Rachel Freyre, Natali Aziz, Midori Katomaeda, Dennis Osmond, Deborah CohanAbstract:OBJECTIVE: To estimate agreement and correlation between the Tuberculin skin test and an interferon gamma release assay for detecting latent tuberculosis (TB) infection in pregnant women. METHODS: We conducted a cross-sectional study of pregnant women initiating prenatal care at a university-affiliated public hospital between January 5, 2009, and March 15, 2010. Eligible women received a questionnaire about TB history and risk factors as well as the Tuberculin skin test and phlebotomy for the interferon gamma release assay. Agreement and correlation between tests were estimated, and different cutoffs for interferon gamma release assay positivity were used to assess effect on agreement. Furthermore, predictors of test positivity and test discordance were evaluated using multivariable analysis. RESULTS: Of the 220 enrolled women, 199 (90.5%) returned for Tuberculin skin test evaluation. Over 70% were Hispanic and 65% were born in a country with high TB prevalence. Agreement between the Tuberculin skin test and interferon gamma release assay was 77.39 (κ=0.26). This agreement was not significantly changed using different cutoffs for the assay. Birth bacille Calmette-Guerin vaccination was associated with Tuberculin skin test positivity (odds ratio [OR] 4.33, 95% confidence interval [CI] 1.4–13.48, P=.01), but not interferon gamma release assay positivity. There were no statistically significant predictors of the Tuberculin skin test and interferon gamma release assay result discordance; however, birth in a high-prevalence country was marginally associated with Tuberculin skin test-positive and interferon gamma release assay-negative results (OR 2.94, 95% CI 0.86–9.97 P=.08). CONCLUSION: Comparing the Tuberculin skin test and interferon gamma release assay results in pregnancy, concordance and agreement were poor. Given that much is still unknown about the performance of interferon gamma release assays in pregnancy, further research is necessary before the Tuberculin skin test is abandoned for screening of latent TB infection in pregnancy. LEVEL OF EVIDENCE: III
Darrell J Irvine - One of the best experts on this subject based on the ideXlab platform.
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temporal dynamics of intradermal cytokine response to Tuberculin in mycobacterium bovis bcg vaccinated cattle using sampling microneedles
Scientific Reports, 2021Co-Authors: Sabine Steinbach, Sasan Jalilifiroozinezhad, Sreenidhi Srinivasan, Mariane B Melo, Sonya Middleton, Timm Konold, Michael Coad, Paula T Hammond, Darrell J IrvineAbstract:Bovine tuberculosis (bTB) is a disease of livestock with severe and worldwide economic, animal welfare and zoonotic consequences. Application of test-and-slaughter-based control polices reliant on Tuberculin skin testing has been the mainstay of bTB control in cattle. However, little is known about the temporal development of the bovine Tuberculin skin test response at the dermal sites of antigen injection. To fill this knowledge gap, we applied minimally-invasive sampling microneedles (SMNs) for intradermal sampling of interstitial fluid at the Tuberculin skin test sites in Mycobacterium bovis BCG-vaccinated calves and determined the temporal dynamics of a panel of 15 cytokines and chemokines in situ and in the peripheral blood. The results reveal an orchestrated and coordinated cytokine and local chemokine response, identified IL-1RA as a potential soluble biomarker of a positive Tuberculin skin response, and confirmed the utility of IFN-γ and IP-10 for bTB detection in blood-based assays. Together, the results highlight the utility of SMNs to identify novel biomarkers and provide mechanistic insights on the intradermal cytokine and chemokine responses associated with the Tuberculin skin test in BCG-sensitized cattle.
Rafaela Borge Loureiro - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness of quantiferon tb gold in tube versus Tuberculin skin test for diagnosis and treatment of latent tuberculosis infection in primary health care workers in brazil
PLOS ONE, 2019Co-Authors: Renata Lyrio Peres, Rafaela Borge Loureiro, Geisa Fregona, Ethel Leonor Noia Maciel, Jonathan E Golub, Rosângela Caetano, Jose Ueleres BragaAbstract:Objectives The goal of this study was to perform a cost-effectiveness analysis from the public health system perspective, comparing five strategies for Latent Tuberculosis Infection (LTBI) diagnosis in primary health care workers in Brazil. Design Analytical model for decision making, characterized by cost-effectiveness analysis. Setting Primary Care Level, considering primary health care workers in Brazil. Participants An analytical model for decision making, characterized by a tree of probabilities of events, was developed considering a hypothetical cohort of 10,000 primary health care workers, using the software TreeAge Pro™ 2013 to simulate the clinical and economic impacts of new diagnostic technology (QuantiFERON®-TB Gold in-Tube) versus the traditional Tuberculin skin test. Methods This model simulated five diagnostic strategies for LTBI in primary health care workers (HCW) in Brazil: Tuberculin skin testing using ≥5 mm cut-off, Tuberculin skin testing ≥10 mm cut-off, QuantiFERON®-TB Gold in-Tube, Tuberculin skin testing using ≥5 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive, Tuberculin skin testing using ≥10 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive. Primary and secondary outcome measures The outcome measures are the number of individuals correctly classified by the test and the number of Tuberculosis cases avoided. Results The most cost-effective strategy was the Tuberculin skin test considering ≥10mm cut-off. The isolated use of the QuantiFERON®-TB Gold In-Tube revealed the strategy of lower efficiency with incremental cost-effectiveness ratio (ICER) of US$ 146.05 for each HCW correctly classified by the test. Conclusions The Tuberculin skin test using ≥10 mm cut-off was the most cost-effective strategy in the diagnosis of Latent Tuberculosis Infection in primary health care works in Brazil.
