Serodiagnosis of tuberculous lymphadenitis using a combination of antigens

Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) by conventional methods such as culture and microscopy has low sensitivity and requires an invasive procedure. A simple rapid serological test would be of great value. Methodology: Six antigens (ESAT-6, Ag85A, TB10.4, Rv3881c, lipoa...

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Main Authors: Demissew Beyene, Kees Lumc Franken, Lawrence Yamuah, Abraham Aseffa, Harald G Wiker, Arend Kolk, Howard Engers, Paul Klatser, Lisbet Sviland
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2010-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/116
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author Demissew Beyene
Kees Lumc Franken
Lawrence Yamuah
Abraham Aseffa
Harald G Wiker
Arend Kolk
Howard Engers
Paul Klatser
Lisbet Sviland
author_facet Demissew Beyene
Kees Lumc Franken
Lawrence Yamuah
Abraham Aseffa
Harald G Wiker
Arend Kolk
Howard Engers
Paul Klatser
Lisbet Sviland
author_sort Demissew Beyene
collection DOAJ
description Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) by conventional methods such as culture and microscopy has low sensitivity and requires an invasive procedure. A simple rapid serological test would be of great value. Methodology: Six antigens (ESAT-6, Ag85A, TB10.4, Rv3881c, lipoarabinomannan (LAM) and Ara6-BSA) were tested in an ELISA to detect antigen-specific IgG and IgM antibodies in sera from 54 culture- and histology-confirmed tuberculous lymphadenitis (TBLN) patients as follows: four were HIV seropositive; sera from 25 was smear positive for pulmonary tuberculosis (PTB); 15 were culture- and histology-negative lymphadenitis (non-TBLN) patients; and 22 werehealthy controls (HCs). Results: The sensitivities of the antigens for the detection of IgG in sera of TBLN patients ranged from 4% to 30%. Specificities ranged from 73% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. Sensitivities of the antigens for detection of IgM ranged from 0% to 15% and specificities ranged from 80% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. LAM was the most potent antigen for detection of IgG. When LAM and ESAT-6 were combined, sensitivity increased up to 43% and specificity with non-TBLN was 80% with HC 96%. Conclusions: The study suggests that the combined use of LAM and ESAT-6 for IgG antibody detection in sera from TBLN patients could be a supplement to microscopy of fine-needle aspirate (FNA) to diagnose TBLN among patients suspected of TBLN.
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spelling doaj-art-9b875c79c1b94fa48682a7fb5331e8bf2025-08-20T02:57:01ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802010-02-0140210.3855/jidc.116Serodiagnosis of tuberculous lymphadenitis using a combination of antigensDemissew Beyene0Kees Lumc Franken1Lawrence Yamuah2Abraham Aseffa3Harald G Wiker4Arend Kolk5Howard Engers6Paul Klatser7Lisbet Sviland8Armauer Hansen Research Institute8Department of Infectious Diseases, Leiden University Medical Center, LeidenArmauer Hansen Research Institute, Addis AbabaArmauer Hansen Research Institute, Addis AbebaSection for Microbiology and Immunology, The Gade Institute, University of Bergen Department of Microbiology and Immunology, Haukeland University Hospital, BergenThe Royal Tropical Institute (KIT), Biomedical Research, Amsterdam1Armauer Hansen Research Institute, Addis AbabaThe Royal Tropical Institute (KIT), Biomedical Research, AmsterdamDepartment of Pathology, Haukeland University Hospital, Bergen, Norway and Section for Pathology, The Gade Institute, University of Bergen Background: The diagnosis of extra-pulmonary tuberculosis (EPTB) by conventional methods such as culture and microscopy has low sensitivity and requires an invasive procedure. A simple rapid serological test would be of great value. Methodology: Six antigens (ESAT-6, Ag85A, TB10.4, Rv3881c, lipoarabinomannan (LAM) and Ara6-BSA) were tested in an ELISA to detect antigen-specific IgG and IgM antibodies in sera from 54 culture- and histology-confirmed tuberculous lymphadenitis (TBLN) patients as follows: four were HIV seropositive; sera from 25 was smear positive for pulmonary tuberculosis (PTB); 15 were culture- and histology-negative lymphadenitis (non-TBLN) patients; and 22 werehealthy controls (HCs). Results: The sensitivities of the antigens for the detection of IgG in sera of TBLN patients ranged from 4% to 30%. Specificities ranged from 73% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. Sensitivities of the antigens for detection of IgM ranged from 0% to 15% and specificities ranged from 80% to 100% with sera from non-TBLN patients and 91% to 100% with sera from HCs. LAM was the most potent antigen for detection of IgG. When LAM and ESAT-6 were combined, sensitivity increased up to 43% and specificity with non-TBLN was 80% with HC 96%. Conclusions: The study suggests that the combined use of LAM and ESAT-6 for IgG antibody detection in sera from TBLN patients could be a supplement to microscopy of fine-needle aspirate (FNA) to diagnose TBLN among patients suspected of TBLN. https://jidc.org/index.php/journal/article/view/116Tuberculous lymphadenitisserological testantigens
spellingShingle Demissew Beyene
Kees Lumc Franken
Lawrence Yamuah
Abraham Aseffa
Harald G Wiker
Arend Kolk
Howard Engers
Paul Klatser
Lisbet Sviland
Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
Journal of Infection in Developing Countries
Tuberculous lymphadenitis
serological test
antigens
title Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
title_full Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
title_fullStr Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
title_full_unstemmed Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
title_short Serodiagnosis of tuberculous lymphadenitis using a combination of antigens
title_sort serodiagnosis of tuberculous lymphadenitis using a combination of antigens
topic Tuberculous lymphadenitis
serological test
antigens
url https://jidc.org/index.php/journal/article/view/116
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