The intrathecal tuberculin reaction

Swithinbank, J.; Smith, Harriet J; Vollum, R. L.

doi:10.1002/path.1700650229

Cited by 35 publications

(15 citation statements)

References 17 publications

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“…tuberculin reaction. 8,9 We previously described serial CSF changes in a group of 99 children on standard oral anti-tuberculosis therapy and found a rise in CSF protein concentrations during the 2nd week of therapy, identical to the changes described in the non-steroid group in the present study. 10 A possible explanation for this rise in CSF protein level during the early stages of TBM treatment was offered by Cho et al who found evidence of increased central nervous system synthesis of immunoglobulin G and of increased permeability of the blood/brain barrier in patients with TBM.…”

Section: Discussionsupporting

confidence: 86%

The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis

Schoeman

Elshof

Laubscher

et al. 2001

Annals of Tropical Paediatrics

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Three recent studies found that corticosteroids improve clinical outcome and mortality in tuberculous meningitis (TBM), although the exact mechanism of action of the drug remains speculative. A number of reports on the effect of corticosteroids on cerebrospinal fluid (CSF) findings in TBM have been published, often with conflicting results regarding serial cell counts and protein levels. As part of a controlled, randomized trial on the effect of oral prednisone on outcome in childhood TBM at our institution, CSF was collected and analysed weekly during the 1st month of treatment. We found no significant difference in serial CSF cell counts between the steroid and non-steroid groups in the study. However, the steroid group had significantly lower CSF protein and globulin levels after the 1st month of treatment, and a more steady rise in CSF glucose levels than the non-steroid group. Knowledge of the different CSF responses during the course of anti-tuberculosis therapy is important in clinical decision-making.

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Section: Discussionsupporting

confidence: 86%

The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis

Schoeman

Elshof

Laubscher

et al. 2001

Annals of Tropical Paediatrics

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“…The protein content tends to follow the same pattern as does the increase in permeability of the blood-C.S.F. barrier as shown by the bromide test (Swithinbank et al, 1953;Smith et al, 1955). The C.S.F.…”

Section: Clinical Materialsmentioning

confidence: 59%

“…when counts of 1,000 or more cells per Dund is in the c.mm. were common (Swithinbank et al, 1953). In cases of tuberculous meningitis a similar sharp rise sions and the in the cell count is the rule.…”

Section: Results Of the Mantoux Testmentioning

confidence: 79%

“…in disseminated sclerosis (Smith, Espir, Whitty, and Russell, 1957). In someone sensitized to tuberculin, whether as a result of natural infection or of vaccination, these injections provoke a wave of meningitis which is the expression of a true, specific allergic reaction (Swithinbank, Smith, and Vollum, 1953). It has been suggested that, in disseminated sclerosis, an alteration in formation and flow of the cerebrospinal fluid (C.S.F.)…”

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confidence: 99%

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Intrathecal Tuberculin in Disseminated Sclerosis: The Immunological Aspects

Hughes¹,

Hunter²

1961

Journal of Neurology, Neurosurgery & Psychiatry

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“…Its detection, nevertheless, is usually associated with the response of a given tissue or organ, particularly the skin. Thus, to detect the hypersensitive condition of a whole animal, the reaction of the skin is measured, although the response of other tissues or organs has been studied, such as the cornea (26,27) and nervous tissue (38). Systemic tuberculin shock is supposedly associated with delayed hypersensitivity and has been used as an expression of delayed allergy (12).…”

Section: Discussionmentioning

confidence: 99%

Hypersensitivity in Newborn Guinea Pigs

Salvin

Gregg

Smith

1962

The Journal of Experimental Medicine

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Delayed hypersensitivity to soluble purified protein develops after injection of antigen into the foot-pads of adult guinea pigs.This antigen may be administered (a) in a specific precipitate in antibody excess (1), (b) in minute quantities (2), or (c) as part of a conjugated protein (3-5). Ultimately, the delayed hypersensitivity may be followed by the appearance of detectable quantities of circulating antibody and the presence of Arthus type hypersensitivity. Formation of circulating antibody has been studied in newborn animals and found deficient when compared to adults (6-10). The presence of delayed hypersensitivity, on the other hand, has not been investigated extensively in newborns.Neonatal guinea pigs sensitized subcutaneously with live tubercle bacilli showed slight, if any, skin reaction to the injection of a watery extract of Mycobacterium tuberculosis despite the presence of gross tuberculous lesions in the regional lymph nodes and spleen (11, 12). The mother pigs under the same conditions showed at the skin-testing site marked erythema, edema, and necrosis. These neonatal animals were approximately as sensitive to the systemic toxic action of old tuberculin injected into the peritoneal cavity as were adult tuberculous guinea pigs. Similar results were described (13) after intraperitoneal sensitization with old tuberculin and skin testing subsequently with the same antigen. Uhr (14), however, demonstrated delayed allergy in newborn guinea pigs 7 to 10 days after foot-pad injection of ovalbumin in complete Freund's adjuvant. The passive transfer of cells from sensitized adults failed to induce delayed hypersensitivity in neonatal guinea pigs, rabbits, and humans (15-17). In contrast, one report (18) describes the passive transfer of tuberculin hypersensitivity after exchange transfusion of infants with blood from tuberculin-positive adults. Contact hypersensitivity, a probable variant of delayed hypersensitivity, has been produced in neonatal infants (19,20). In view of the evidence that newborn animals respond less readily than adults to antigenic stimuli, studies were initiated to determine the ability of neonatal guinea pigs to manifest delayed hypersensitivity under a variety of test conditions.In this paper, results are presented indicating that newborn guinea pigs can develop delayed hypersensitivity, but do not manifest it in the skin after intradermal injection of antigen. 707 on

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The intrathecal tuberculin reaction

Cited by 35 publications

References 17 publications

The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis

The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis

Intrathecal Tuberculin in Disseminated Sclerosis: The Immunological Aspects

Hypersensitivity in Newborn Guinea Pigs

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