Serodiagnosis of asthmatic tuberculous adult patients

ABSTRACT

This study was conducted on 30 adult patients with bronchial asthma, out of them 10 suffering also from chronic pulmonary tuberculosis. These cases were selected by systematic random sampling from the attendants of the allergy unit. Microbiology Department. Faculty of Medicine. Zagazig University during the year 1993. A control group of 30 apparently healthy adults crossly matched with cases was selected. Thorough history taking, clinical, sputum and radiological examinations for cases and control were made and cases were categorized into 2 groups. Group I included 10 asthmatics with pulmonary tuberculosis and group II included 20 patients with bronchial asthma only. It was found that house dust and house dust mite were the most prevalent allergens among the studied cases [43.3% and 33.3% respectively]. Positivity of skin testing to these allergens was mostly higher than the corresponding allergen specific IgE levels. Circulating immune complexes [CICs] levels were neither related to severity of asthma nor positivity of skin testing [P < 0.05] but most tuberculosis patients of group I [80.0%] had higher levels of CICs. It was also revealed that neither Zeil-Nelson staining nor culture methods of sputum could detect tubercle bacilli among group I with pulmonary shadowing suggestive of clinical tuberculosis. The most sensitive method for serodiagnosis of tuberculosis of ELISA [90.0%] followed by Indirect Immunofluoresent Antibody test [IFA. 80.0%] and lastly Passive Haemagglutination Test [PHT, 60.0%]