RESUMEN
SETTING: It is generally accepted that antibodies do not protect against Mycobacterium tuberculosis infection, as this role relies upon T-cell reactivity. Hence, most studies on antimycobacterial antibodies have been aimed at developing serologic tests, and few explore their role in disease pathogenesis. OBJECTIVE: To determine the IgG antimycobacterial antibody response of 55 Mexican Totonaca Indians with pulmonary tuberculosis and its correlation with some features of the disease. DESIGN: Study of the profile of antigen recognition by immunoblot and ELISA with isolated antigen 85 complex (Ag85) and whole culture filtrate proteins. Correlation of immunoblot and ELISA results with BCG vaccination, tuberculin reactivity, extent of the disease, clinical setting, and response to treatment. RESULTS: On immunoblot, band reactivity was very poor and the most frequently recognized antigen was the 30-32 kDa, antigen 85 complex (45.8% of serum samples). ELISA with this antigen showed a sensitivity of 72% and a specificity of 100%. Positive antibody titers to Ag85 were observed in 79.4% of patients with non-cavitary tuberculosis (P = 0.012) and in 95.8% of patients who were cured with anti-tuberculosis chemotherapy (P = 0.0001). By contrast, an antibody response to whole culture filtrate antigens had no correlation with the presence of cavitations or with prognosis. CONCLUSIONS: Our data show that an antibody response to Ag85, aside from having great potential to develop a serologic test for tuberculosis, was associated with a positive outcome in a cohort of tuberculous Mexican Indians.
Asunto(s)
Aciltransferasas/inmunología , Antígenos Bacterianos/inmunología , Inmunoglobulina G/inmunología , Indígenas Norteamericanos , Mycobacterium tuberculosis/inmunología , Tuberculosis Pulmonar/inmunología , Adulto , Formación de Anticuerpos , Vacuna BCG , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Immunoblotting , Masculino , México , Estudios Prospectivos , Tuberculosis Pulmonar/etnologíaRESUMEN
We inform of one case of fever and characteristic hepatic granuloma in which the final diagnosis was Q fever. The interest of this case lies in the fact that the patient did not have the usual epidemiological antecedent and its typical clinical presentation.
Asunto(s)
Granuloma/etiología , Hepatitis/etiología , Hepatopatías/etiología , Fiebre Q/complicaciones , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Biopsia , Granuloma/diagnóstico , Granuloma/patología , Hepatitis/diagnóstico , Hepatitis/patología , Humanos , Hígado/patología , Hepatopatías/diagnóstico , Hepatopatías/patología , Masculino , Persona de Mediana Edad , Fiebre Q/diagnóstico , Fiebre Q/tratamiento farmacológico , Tetraciclina/administración & dosificación , Tetraciclina/uso terapéutico , Factores de TiempoRESUMEN
Circadian variation of temperature, both normal and febrile, is a well known fact. Mediators of fever are also regulators of acute phase response and are associated with stimulation of pituitary hormone production related with defervescence and with a circadian pattern of secretion. Acute phase response may consequently have circadian variations in its components. Measurements of temperature, erythrocyte sedimentation rate, complete blood cell count, serum cortisol and fibrinogen were made at 7:00, 15:00, and 23:00 h during two consecutive days in 35 patients with fever and acute infection, 15 patients with clinically active ankylosing spondylitis without fever and 10 healthy volunteers. Temperature curves showed statistically significant circadian rhythms, with higher values at night and lower ones during early morning. Erythrocyte sedimentation rate, leukocyte count and fibrinogen also showed statistically significant circadian rhythms, but with higher values at 15:00 h. Serum cortisol also showed statistically significant circadian rhythmicity but with a higher rhythm adjusted mean (MESOR), and a 100 degrees (6 h) phase shift in patients with fever, as compared to patients with ankylosing spondylitis and healthy controls. In conclusion, components of acute phase response, including fever, have circadian rhythmicity, but asynchronically. Differences between fever and ankylosing spondylitis can be due to the intensity of acute phase response stimulation.