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Mem. Inst. Oswaldo Cruz ; 105(5): 722-728, Aug. 2010. graf, tab
Article Dans Anglais | LILACS | ID: lil-557238

Résumé

To evaluate commercial Lionex TB together with four antigens of Mycobacterium tuberculosis (MPT-64, MT10.3, 16 kDa and 38 kDa) for IgG and IgA cerebrospinal fluid (CSF) detection in the diagnosis of tuberculosis meningitis (TBM) with CSF negative acid-fast bacilli staining, 19 cases of TBM, 64 cases of other infectious meningoencephalitis and 73 cases of other neurological disorders were tested by enzyme linked immunosorbent assay. IgA-MPT-64 and IgG Lionex showed the highest sensitivities, specificities, positive predictive value and negative predictive value (63.2 percent, 47.4 percent; 95 percent, 93.7 percent; 40 percent, 98 percent and 28.4 percent, 97.1 percent, respectively). However, while grey zone was 12.7 percent and 6 percent, respectively, lowering sensitivity but maintains high specificity (> 95 percent). High protein concentration in CSF was associated with antibody positivity CSF/HIV+ which did not influence the sensitivity of both tests. To our knowledge, this is the first description of IgA-MPT-64 and IgG Lionex antibodies in CSF-TBM and, although there is good specificity, adjustments are needed based on antigen composition to enhance sensitivity.


Sujets)
Humains , Anticorps antibactériens/liquide cérébrospinal , Antigènes bactériens , Immunoglobuline A/liquide cérébrospinal , Immunoglobuline G/liquide cérébrospinal , Mycobacterium tuberculosis/immunologie , Méningite tuberculeuse , Test ELISA , Mycobacterium tuberculosis , Valeur prédictive des tests , Trousses de réactifs pour diagnostic , Sensibilité et spécificité , Méningite tuberculeuse/liquide cérébrospinal , Méningite tuberculeuse/immunologie
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