The major objective was to evaluated the sensitivity and specificity of anti-LAM IgG antibodies for diagnosis of tuberculosis in cases of pulmonary, extrapulmonary and associated forms.
It was a study of diagnostic test using a specific antigen, designed Lipoarabinomannan (LAM) of Cambridge, MA, USA, Dyna-Gen Company. This test was performed in patients from our hospital, during january 1996 to december 1998. There are a case group and a control group without tuberculosis (TB).
The casuistic was 173 patients with tuberculosis, confirmed by bacteriologic and/or anatomopathologic methods in 114 cases (68,8%). In the other cases, the tuberculosis was confirmed by clinical, radiological features and follow up of the patients after chemoterapy. The series presented 115 males, 58 females; 131 was caucasian, 24 black and 18 was non-caucasian. The total pulmonary forms was 88 cases (51%), 81 with positive AFB in sputum and 7 with negative AFB in sputum. Three have positive culture, two with negative cultures. Extrapulmonary tuberculosis was found in 71 cases (41%). The predominant forms of X-ray of the thorax was miliar and necrositing lesions. HIV-positive patients were 118 and negative 55. The MycoDot test results were: positive in 120 patients (69,4%) and negative in 53 patients (30,6%). In control group, MycoDot was negative in 73 cases (94,8%) and positive in 4 cases (5,2%). The final results were: sensitivity of 69,4%, specificity of 94,8%, the positive predictive value was 96,8% and the negative predictive value was 57,9%. In HIV-positive patients, the sensibility was 61,8% and the specificity was 100%.CONCLUSIONS: The conclusions were the MycoDot test is easy and ideal for use in the diagnosis of active tuberculosis in special cases in conjunction with the other methods and permit to evaluate the humoral immunity.
These diagnostic method represents other form to evaluate TB, especially in extrapulmonary forms.
L.A. Henn, None.