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首页> 外文期刊>Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG >Anergy to tuberculin in sarcoidosis is not influenced by high prevalence of tuberculin sensitivity in the population.
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Anergy to tuberculin in sarcoidosis is not influenced by high prevalence of tuberculin sensitivity in the population.

机译：结节病患者对结核菌素的无反应性不受人群中结核菌素敏感性高流行的影响。

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摘要

BACKGROUND AND AIM: To study the pattern of tuberculin sensitivity and its interpretation to diagnose sarcoidosis in the presence of a high prevalence of Mantoux positivity in the general population in India. METHODS: Tuberculin sensitivity was examined in two groups of subjects: Group I included 50 newly diagnosed patients with pulmonary sarcoidosis and two control subjects with pulmonary ailments other than sarcoidosis or tuberculosis for each case; Group II included 62 new patients with sarcoidosis and 130 healthy volunteers as control subjects. Mantoux test was performed using 1 TU tuberculin. The test was repeated with 5 TU tuberculin for those cases and controls who were anergic to 1 TU among the group II subjects. Sensitivity and specificity for a "negative Mantoux test" in sarcoidosis were calculated at different cutoff points. The influence of prior BCG vaccination status on the performance of Mantoux test was also studied. MEASUREMENTS AND RESULTS: Forty-six (92%) of the 50 patients with sarcoidosis in Group I and 55 of the 62 (88.7%) in Group II did not show any reaction to Mantoux test, compared to 32 (32%) and 21 (16.2%) controls, respectively in groups I and II (P < 0.001). Thirty-nine (70.9%) of the 55 patients and 6 (28.6%) of the 21 controls from the group II subjects who were tested again with 5 TU did not show any reaction. A negative Mantoux test had a high sensitivity value at all the cut off points for the diagnosis of sarcoidosis. BCG vaccination administered during childhood had no correlation with a negative Mantoux reaction. CONCLUSIONS: Tuberculin anergy in sarcoidosis is not influenced by the rate of Mantoux positivity in the general population. A positive Mantoux test (irrespective of the size of reaction) in a suspected case of sarcoidosis should arouse strong suspicion of an alternate or an additional diagnosis of tuberculosis.
机译：背景与目的：研究在印度普通人群中Mantoux阳性率较高的情况下，结核菌素敏感性模式及其对结节病的诊断方法。方法：对两组受试者的结核菌素敏感性进行了检查：第一组包括50例新诊断的肺结节病患者和两名除结节病或结核病以外的肺部疾病对照组。第二组包括62名结节病新患者和130名健康志愿者作为对照组。使用1 TU结核菌素进行Mantoux测试。对于II组受试者中对1 TU无反应的那些病例和对照，使用5 TU结核菌素重复该测试。在不同的临界点计算结节病中“阴性Mantoux试验”的敏感性和特异性。还研究了先前的卡介苗接种状况对Mantoux测试性能的影响。测量和结果：第一组的50例结节病患者中有46（92％）名，第二组的62名（55.7％）中有55名对Mantoux试验没有任何反应，而32名（32％）和21名I和II组分别有（16.2％）对照（P <0.001）。 II组受试者的55名患者中有39名（70.9％）和21名对照中的6名（28.6％）用5 TU进行了再次测试，未显示任何反应。曼图氏试验阴性在诊断结节病的所有临界点均具有较高的敏感性值。儿童时期进行的BCG疫苗接种与Mantoux阴性反应无关。结论：结节病中的结核菌素无反应性不受普通人群中Mantoux阳性率的影响。在疑似结节病病例中，Mantoux试验呈阳性反应（与反应大小无关），应引起人们强烈怀疑结核病的替代或附加诊断。

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