{"id":2044,"date":"2009-10-26T18:56:00","date_gmt":"2009-10-27T00:56:00","guid":{"rendered":"http:\/\/medicinainterna.com.mx\/2009\/10\/26\/diagnostico-de-tb-activa-a-traves-de-respuesta-inmyne-de-celulas-mononucleares-obtenidas-de-lavado-broncoalveolar"},"modified":"2009-10-26T18:56:00","modified_gmt":"2009-10-27T00:56:00","slug":"diagnostico-de-tb-activa-a-traves-de-respuesta-inmyne-de-celulas-mononucleares-obtenidas-de-lavado-broncoalveolar","status":"publish","type":"post","link":"https:\/\/medicinainterna.com.mx\/?p=2044","title":{"rendered":"Diagnostico de TB activa a traves de respuesta inmyne de celulas mononucleares obtenidas de lavado broncoalveolar"},"content":{"rendered":"<div id=\"articleArea\"><span style=\"font-size: small;\"><span style=\"font-size: small;\"><br \/>\n<\/span><\/span><\/p>\n<div id=\"articleArea\">\n<h1><span style=\"font-family: Arial; font-size: small;\">Immune Response from Bronchoalveolar Lavage Mononuclear Cells Diagnoses Active TB<\/span><\/h1>\n<p><i><span style=\"font-family: Arial; font-size: small;\">ELISpot performed on bronchoalveolar mononuclear cells had a sensitivity of 91% and a specificity of 79% in diagnosing active disease. <\/span><\/i><\/p>\n<div id=\"articleArea\">\n<p><span style=\"font-family: Arial; font-size: small;\">Rapid diagnosis of active pulmonary TB is difficult. Microscopy for identifying acid-fast bacilli is quick, but it is negative in 50% of those with active disease; nucleic acid amplification tests also have low sensitivity. In active TB, <i>Mycobacterium tuberculosis<\/i>\u2013specific lymphocytes are activated at the site of infection. Results of a pilot study (<\/span><a href=\"http:\/\/infectious-diseases.jwatch.org\/cgi\/content\/full\/2006\/1115\/4\"><span style=\"font-family: Arial; font-size: small;\">JW Infect Dis Nov 15 2006<\/span><\/a><span style=\"font-family: Arial; font-size: small;\">) have suggested that response by bronchoalveolar lavage fluid mononuclear cells (BALMCs) to two <i>M. tuberculosis<\/i> antigens, ESAT-6 and CFP-10, is significantly increased in patients with active pulmonary TB but not in those with latent disease.<\/span><br \/>\n<span style=\"font-family: Arial; font-size: small;\">As a follow-up to this work, investigators (some with support from the assay manufacturer) performed an enzyme-linked immunospot (ELISpot) test on peripheral blood mononuclear cells (PBMCs) and BALMCs from 347 patients with suspected active TB. Seventy-one of the patients were eventually determined to have active TB; the remaining 276 had other conditions. ELISpot on BALMCs had a sensitivity of 91% and a specificity of 79% in diagnosing active TB (diagnostic odds ratio, 27; <i>P<\/i>&lt;0.001). Moreover, among patients with a positive PBMC ELISpot, the BALMC ELISpot was positive in 55 of the 60 with active TB (92%) and negative in 82 of the 116 without active TB (71%; <i>P<\/i>=0.0012), demonstrating that BALMC ELISpot distinguished active from latent TB.<\/span><br \/>\n<span style=\"font-size: small;\"><span style=\"font-family: Arial;\">Comment: This assay has two drawbacks: It requires an invasive procedure (bronchoalveolar lavage), and results can be indeterminate. However, the test is clearly useful for rapidly establishing the diagnosis of active TB and has applicability in other pulmonary infections, such as the endemic mycoses.<\/span><\/span><br \/>\n<i><span style=\"font-family: Arial; font-size: small;\">\u2014 <\/span><a href=\"http:\/\/infectious-diseases.jwatch.org\/misc\/board_about.dtl#aAmpel\"><span style=\"font-family: Arial; font-size: small;\">Neil M. Ampel, MD<\/span><\/a><\/i><br \/>\n<span style=\"font-size: small;\"><span style=\"font-family: Arial;\"><i>Published in<\/i> <\/span><\/span><a href=\"http:\/\/infectious-diseases.jwatch.org\/\"><span style=\"font-family: Arial; font-size: small;\">Journal Watch Infectious Diseases<\/span><\/a><span style=\"font-size: small;\"><span style=\"font-family: Arial;\"> <i>October 21, 2009<\/i><\/span><\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<hr \/>\n<div class=\"blogger-post-footer\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" src=\"https:\/\/blogger.googleusercontent.com\/tracker\/3335219593278186444-4069307320096220544?l=www.medinterna.com.mx\" width=\"1\" height=\"1\" \/><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Immune Response from Bronchoalveolar Lavage Mononuclear Cells Diagnoses Active TB ELISpot performed on bronchoalveolar mononuclear cells had a sensitivity of 91% and a specificity of 79% in diagnosing active disease. Rapid diagnosis of active pulmonary TB is difficult. Microscopy for identifying acid-fast bacilli is quick, but it is negative in 50% of those with active &hellip; <a href=\"https:\/\/medicinainterna.com.mx\/?p=2044\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Diagnostico de TB activa a traves de respuesta inmyne de celulas mononucleares obtenidas de lavado broncoalveolar&#8221;<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[12],"tags":[],"class_list":["post-2044","post","type-post","status-publish","format-standard","hentry","category-interesantes"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/2044","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2044"}],"version-history":[{"count":0,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/2044\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2044"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2044"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2044"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}