Diagnosis of tuberculous lymphadenitis by molecular and immunological tools

Nitin Kumar , Anish Khan , Sanjit Boora , Neha Chadha , Nisha Khan , Puneet Raina , Rajesh Gupta , Raj Singh , Samander Kaushik
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Abstract

Introduction

Tuberculous lymphadenitis (TBL) represents the prevailing presentation of extrapulmonary tuberculosis (EPTB) that comprises ∼35 % of EPTB cases, respectively and mainly occurs at cervical lymph nodes. Diagnostic challenge in TBL is primarily due to paucibacillary nature of specimens, and most common laboratory tests produced inconclusive findings.

Areas covered

We evaluated the literature on current diagnostic methods for TBL. Smear microscopy, culture, tuberculin skin test, interferon-γ release assay, biochemical assessments, imaging, histopathological, and cytological examination, etc. are various conventional methods used to diagnose TBL but these are insufficient. Further, nucleic acid amplification tests (NAATs) such as loop-mediated isothermal amplification (LAMP), PCR/multiplex-PCR, nested-PCR, real-time PCR, and GeneXpert®MTB/RIF utilized for TBL diagnosis but they have their own merits and demerits. Presently, several tools have been employed for detection of circulating Mtb cell-free DNA (cfDNA) through NAATs, aptamer-linked immobilized sorbent assay, and immuno-PCR (I-PCR), etc.

Conclusion

Currently, there is no single accessible test available for effective diagnosis of TBL. In this review, we summarized all detailed conventional methodologies along with additional tools such as ALISA, I-PCR, and cfDNA for detection of Mtb biomarkers that have been utilized for diagnosis of pulmonary TB (PTB) and various forms of EPTB that may also be investigated for diagnosis of TBL. Early diagnosis and treatment would help in reducing the severe complications associated with TBL such as fistula, ulceration, or abscess formation in lymph nodes.
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利用分子和免疫学工具诊断结核性淋巴结炎
导言结核性淋巴结炎(TBL)是肺外结核(EPTB)的主要表现形式,占肺外结核病例的35%,主要发生在颈淋巴结。TBL的诊断难题主要在于标本的贫弱性,而且大多数常见的实验室检测都无法得出结论。涂片显微镜检查、培养、结核菌素皮肤试验、干扰素-γ释放测定、生化评估、影像学、组织病理学和细胞学检查等是诊断 TBL 的各种常规方法,但这些方法并不充分。此外,环介导等温扩增(LAMP)、聚合酶链反应/多重聚合酶链反应、巢式聚合酶链反应、实时聚合酶链反应和 GeneXpert®MTB/RIF 等核酸扩增检测(NAAT)也被用于 TBL 诊断,但这些方法各有利弊。目前,已有几种工具通过 NAATs、aptamer-linked 固定吸附剂检测法和免疫 PCR (I-PCR) 等方法检测循环中的 Mtb 细胞游离 DNA (cfDNA)。在这篇综述中,我们总结了所有详细的传统方法以及 ALISA、I-PCR 和 cfDNA 等其他检测 Mtb 生物标记物的工具,这些方法已被用于诊断肺结核(PTB)和各种形式的 EPTB,也可用于 TBL 的诊断。早期诊断和治疗将有助于减少与 TBL 相关的严重并发症,如瘘管、溃疡或淋巴结脓肿的形成。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medicine in Microecology
Medicine in Microecology Medicine-Gastroenterology
CiteScore
5.60
自引率
0.00%
发文量
16
审稿时长
76 days
期刊最新文献
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