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Free Content Cytokine production in patients with tuberculous pericarditis

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SETTING: An academic hospital in the Western Cape, South Africa.

OBJECTIVE: To evaluate cytokine production (interferon-gamma [IFN-γ], interleukin-1 [IL-1], interleukin-2 [IL-2], interleukin-6 [IL-6], interleukin-10 [IL-10], interleukin-4 [IL-4] and tumour necrosis factor-alpha [TNF-α]) in patients with tuberculous pericarditis.

DESIGN: Subpopulation of a consecutive prospective case series.

PATIENTS: Thirty patients presenting with pericardial effusions due to tuberculosis (n = 19), malignancy (n = 6) and non-tuberculous infections (n = 5), and five control subjects who had undergone open heart surgery.

RESULTS: The concentration of IFN-γ was significantly higher in tuberculous pericardial effusions than in the other diagnostic classes (P < 0.0005). The concentration of TNF-α was similar in both infective and tuberculous effusions, but was significantly higher than that of malignant effusions. IL-1 and IL-2 were undetectable in malignant effusions, but elevated in both infective and tuberculous pericardial effusions. The levels of IL-1 and IL-2 were furthermore significantly higher in pericardial effusions due to infective compared to tuberculous causes. The concentration of IL-6, while elevated in all diagnostic classes, was significantly higher in the malignant group. Elevated levels of IL-10 and undetectable levels of IL-4 were observed in all three diagnostic groups.

CONCLUSION: These findings suggest that tuberculous pericardial effusions arise due to a hypersensitivity reaction that is orchestrated by the TH-1 lymphocytes.

Keywords: IFN-; TNF-; cytokines; tuberculous pericarditis

Document Type: Regular Paper

Affiliations: 1: Departments of Chemical Pathology and Cardiology, Tygerberg Hospital and University of Stellenbosch, Tygerberg, South Africa 2: Department of Cardiology, Tygerberg Hospital and University of Stellenbosch, Tygerberg, South Africa 3: Department of Chemical Pathology, Tygerberg Hospital and University of Stellenbosch, Tygerberg, South Africa

Publication date: May 1, 2002

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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