Detection of specific antibody to mycobacterial antigen 60 in tuberculous pleural effusion.

BACKGROUND

With the development of the enzyme-linked immunosorbent assay (ELISA) method, serodiagnosis of tuberculosis has been studied by many investigators. Only a few studies have been performed in pleural fluid. This study was designed to evaluate the IgG antibody levels to mycobacterial antigen 60 (Ag60) in pleural fluid, and evaluate its role in the diagnosis of tuberculous pleurisy.

METHODS

Eighteen patients with tuberculous pleural effusions and 18 patients with malignant pleural effusions were studied. The levels of IgG antibodies to Ag60 in pleural fluids were measured by ELISA method.

RESULTS

The mean titers of IgG against Ag60 in pleural fluids of tuberculous patients (508.3 +/- 382.7 EU) were significantly higher than those of the mean value of the malignant group (131.2 +/- 83.2 EU). In the TB pleurisy group, patients with positive M. tuberculosis cultures from pleural fluids had significantly higher titers than those with negative cultures (796.5 +/- 394.7 vs 277.8 +/- 150.2 EU); patients with impaired immune function had significantly lower titers than those without (138.4 +/- 28.9 vs 650.6 +/- 358.1 EU). Using 250 EU as a cutoff value for a positive test, the sensitivity was 72.2% and the specificity, 94.4%.

CONCLUSIONS

ELISA method using Ag60 is a rapid test with an acceptable sensitivity and excellent specificity for differentiation between tuberculous and malignant pleural effusion.