Authors: Elkayam, O.¹; Caspi, D.²; Lidgi, M.³; Segal, R.⁴

Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 3, March 2007 , pp. 306-310(5)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

OBJECTIVES: To determine the prevalence of a wide array of auto-antibodies in patients with tuberculosis (TB) compared with healthy controls.

MATERIALS AND METHODS: Forty-seven consecutive patients (age 47 ± 21 years, 29 males) with recently diagnosed active pulmonary tuberculosis (PTB) and 39 healthy controls were enrolled. Data collected on a questionnaire included clinical features of the disease, duration of symptoms, presence of fever, cough, arthralgia, myalgia, sicca symptoms and others. Serum samples were collected from the patients' before initiating TB treatment, frozen at −20°C and tested for antinuclear antibodies (ANA), anti-ds DNA, anti-Sm, anti-RNP, anti-Ro, anti-La, and anti-cardiolipin (ACA) (IgG and IgM).

RESULTS: Rheumatic symptoms were relatively rare: arthralgia (n = 2), myalgias (n = 2), and eye (n = 1) and mouth dryness (n = 4). The TB patients' mean serum levels of anti-ds DNA, anti-Sm, anti-RNP, anti-SSA (anti-Ro), and anti-ACA-IgM were significantly increased compared with controls (P < 0.05 for all). A significantly higher proportion of TB patients had increased pathological levels of anti-ds DNA (32% vs. 2.5%), anti-Sm (38% vs. 0%), anti-RNP (15% vs. 0%), anti-Ro (64% vs. 10%), anti-ACA-IgG (59% vs. 0%) and anti-ACA-IgM (47% vs. 7.7%) (P < 0.05 for all).

CONCLUSIONS: Patients with active TB have significantly increased titres of various auto-antibodies, including highly specific serological markers, such as anti-Sm.

RELEVANCE: Differential interpretation of serological studies of patients with systemic manifestations should consider the possibility of PTB.

Keywords: ANA; auto-antibodies; anti-Sm; cardiolipin; tuberculosis

Document Type: Regular paper

Affiliations: 1: Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Medicine F, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 2: Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 3: Department of Tuberculosis, Shmuel-Harofeh Geriatric Medical Centre, Tel Aviv, Israel 4: Department of Medicine F, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Geriatrics, Shmuel-Harofeh Geriatric Medical Centre, Tel Aviv, Israel

Publication date: 2007-03-01

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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.

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