Variably Acid-Fast Bacteria in a Case of Systemic Sarcoidosis and Hypodermitis Sclerodermiformis

Cantwell, Alan R.

doi:10.1159/000250168

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…These include: histopathological appearances of the granulomas [2]; reports of mycobacterial disease either existing coincidentally, succeeding or pre-dating sarcoidosis [59,60]; and the finding of mycobacteria in occasional granulomas of sarcoidosis [61][62][63]. Passage experiments have also suggested that mycobacteria with characteristics of M. tuberculosis may be the incriminating agent [64][65][66][67].…”

Section: Trials Excludedmentioning

confidence: 99%

Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis

Gupta¹,

Agarwal²,

An³

et al. 2007

Eur Respir J

191

120

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The aetiology of sarcoidosis is currently unknown. Due to the clinical and histological similarities between sarcoidosis and tuberculosis, the role of mycobacteria has been repeatedly investigated as an aetiological agent for sarcoidosis. The current meta-analysis aimed to evaluate the available molecular evidence on the possible role of mycobacteria in the development of sarcoidosis.The MEDLINE, EMBASE, CINAHL, DARE and CENTRAL databases were searched for relevant studies published from 1980 to 2006, and studies evaluating the presence of mycobacteria using molecular techniques in biological samples of patients with sarcoidosis were included in the current analysis. The 95% confidence intervals (CI) were calculated for the expected proportion (of individual studies); the data was then pooled to obtain a summary success rate with 95% CI. The odds ratio (95% CI) was also calculated in order to assess the presence of mycobacteria in samples of patients with sarcoidosis versus those from nonsarcoidosis control samples.The database search yielded 31 studies. All studies used polymerase chain reaction for nucleic acid amplification followed by identification of nucleic acid sequences specific for different types of mycobacteria. Overall, 231 out of the 874 patients were positive for mycobacteria with a positive signal rate of 26.4 (23.6-29.5%), and the odds of finding mycobacteria in samples of patients with sarcoidosis versus controls were 9.67 (4.56-20.5%) using the random effects model and 19. 49 (11.21-35.54%) using the exact method. There was methodological and statistical heterogeneity and evidence of publication bias.The results of the current study illustrate a demonstrable mycobacterial presence in sarcoidosis lesions suggesting an association between mycobacteria and some cases of sarcoidosis. To avoid methodological diversity, larger multicentre trials with a central laboratory for sample testing should be designed.

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Section: Trials Excludedmentioning

confidence: 99%

Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis

Gupta¹,

Agarwal²,

An³

et al. 2007

Eur Respir J

191

120

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“…A mouse monoclonal antibody was developed against M tuberculosis H37RV whole cell antigen using the Kohler-Milstein technique.27 One gram of wet cell pellet of bacteria was suspended in 10 USA). Plates with cell suspensions were centrifuged at 1200 rpm for 10 minutes, the wells were aspirated, washed with a Tween 80 (0-05%) saline (0 85%) wash solution, and filled with ethylene glycol for five minutes to fix antigen to the plastic wells.…”

Section: Assessment Of Monoclonal Antibody Specificitymentioning

confidence: 99%

Growth of acid fast L forms from the blood of patients with sarcoidosis.

Almenoff¹,

Johnson²,

Lesser³

et al. 1996

Thorax

101

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Background -Acid fast cell wall deficient forms (CWDF) of bacteria have been grown from blood, bronchial washings, and ocular anterior chamber fluid from patients with sarcoidosis. A monoclonal antibody raised against Mycobacterium tuberculosis whole cell antigen (H37RV) was used to characterise further CWDF grown from the blood of patients with sarcoidosis. Methods -Blood from 20 patients with active sarcoidosis and from 20 controls was cultured using methods favourable for the growth of CWDF. Isolates were further characterised by indirect fluorescent antibody analysis using a monoclonal antibody highly reactive with M tuberculosis. Results -CWDF were grown from the blood of 19 of 20 subjects with sarcoidosis. All isolates stained positively with the monoclonal antibody and with a modified Kinyoun stain. No organisms were grown from the blood of controls.Conclusions -These data demonstrate that CWDF can be grown from the blood of nearly all patients with active sarcoidosis. The results confirm that the organisms are mycobacterial in origin and are similar, if not identical, to M tuberculosis. Their role in the pathogenesis of sarcoidosis is unknown. (Thorax 1996;51:530-533)

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“…Several investigators have described the presence of bacterial structures in various samples from patients with sarcoidosis (47)(48)(49)(50)(51)(52). Initially, these structures were characterized as cell wall-deficient (CWD) bacteria (50,51) and later as acid-fast bacilli (AFB).…”

Section: Histology and Bacteriologymentioning

confidence: 99%