Rapid diagnosis in early stage renal tuberculosis by real-time polymerase chain reaction on renal biopsy specimens
Abstract:OBJECTIVE: To determine the early rapid diagnosis of renal tuberculosis (RTB) by real-time polymerase chain reaction (PCR) on renal biopsy specimens.
METHODS: Ninety patients were selected for this study. The patients were divided into the following three groups: RTB, non-RTB (N-RTB) and clinically suspected RTB (CS-RTB). The renal biopsy specimens of these patients were used for Mycobacterium tuberculosis DNA detection by real-time PCR, using 35 and 40 as cycle threshold (CT) cut-off values. Morning urine samples were collected for M. tuberculosis culture.
RESULTS: In the RTB group, 25 CT35 and 28 CT40 patients were PCR-positive, seven of whom were urine M. tuberculosis culture-positive. In the N-RTB group, four CT35 and 13 CT40 patients were PCR-positive, none of whom were urine M. tuberculosis culture-positive. In the CS-RTB group, nine CT35 and 14 CT40 patients were PCR-positive, two of whom were urine M. tuberculosis culture-positive during 12 months of follow-up. The sensitivity and specificity of real-time PCR (CT40) were respectively 93.3% and 56.7%. The sensitivity and specificity of real-time PCR (CT35) were respectively 83.3% and 86.7%. The sensitivity and specificity of the urine M. tuberculosis culture were respectively 23.3% and 100%.
CONCLUSIONS: The detection of M. tuberculosis DNA in renal biopsy tissue by real-time PCR is highly sensitive. Real-time PCR can increase diagnostic accuracy and provide valuable information regarding the early diagnosis of RTB.
Document Type: Regular Paper
Affiliations: 1: Department of Nephrology, First Affiliated Hospital of China Medical University, Shenyang, China 2: Department of Osteology, Shengjing Hospital of China Medical University, Shenyang, China 3: Department of Urology, First Affiliated Hospital of China Medical University, Shenyang, China
Publication date: 2010-03-01
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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