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Sera from patients with active pulmonary tuberculosis and pulmonary diseases frequently mimicking tuberculosis were assayed for immunoglobulin G antibody activity to purified protein derivative (PPD) by an enzyme-linked immunosorbent assay. A method of standardization was developed to limit assay variation. Patients with active pulmonary tuberculosis had a significantly greater mean level of antibody than had patients with atypical tuberculosis (P = 0.005), sarcoidosis (P = 0.0001), histoplasmosis (P = 0.004), blastomycosis (P = 0.008), or cryptococcosis (P = 0.017), patients who had received bacille Calmette-Guérin vaccination (P = 0.003) or who had a history of treated tuberculosis (P = 0.003), and PPD skin test-positive and skin test-negative control subjects (P = 0.001). This technique may have potential use as a rapid diagnostic aid in evaluating patients with suspected active pulmonary tuberculosis.

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