Constrictive pericarditis: detection of mycobacterium tuberculosis in paraffin-embedded pericardial tissues by polymerase chain reaction.

BACKGROUND

Although the utility of polymerase chain reaction (PCR) for diagnosis of acute pleuro-pericardial tuberculosis has been well established, its use for chronic constrictive pericarditis is yet to be reported.

AIMS: To define the sensitivity and specificity of PCR for diagnosis of tuberculosis (TB) in patients with constrictive pericarditis.

METHODS

The medical records of 30 consecutive patients with constrictive pericarditis were reviewed. In addition their historical paraffin-embedded pericardial tissues were used for new histopathologic examination and PCR amplification for Mycobacterium tuberculosis genome.

RESULTS

There were 23 males and 7 females with a mean age of 35+/-19.5 years. The anticipated causes of constriction included idiopathic (n=21), tuberculosis (n=5), cardiac surgery (n=2) and post traumatic (n=2). PCR became positive in nine patients. Four out of 5 patients with tuberculous granuloma had a positive test result. In addition all 4 patients with non-tuberculous constrictive pericarditis had a negative test result. Therefore considering the presence or absence of granuloma as a diagnostic criteria, the sensitivity and specificity of PCR were 4/5 (80%) and 20/25 (80%), respectively.