Immune status in patients with subclinical forms of genitourinary tuberculosis

The study aim was to determine whether there is a correlation between subclinical forms of genitourinary tuberculosis (GUTB) and immune status. All patients admitted to the Pneumology Clinic of the Thomayer Hospital, Prague with lung tuberculosis (LTB) were enrolled in the study. The study group consisted of 102 patients, 75 males and 27 females, median age of 46.8 years. In a previously published part of the study, 6.9 % of LTB patients were diagnosed with subclinical forms of GUTB. In the present part of the study, immune status was determined in patients with subclinical forms of GUTB by measuring circulating immunoglobulin G and CD4 T cell levels. The comparison of the immunological results did not show a statistically significant difference between the patients diagnosed with GUTB and other LTB patients..

Poncet's disease (tuberculous rheumatism): two case reports and review of the literature

We report two human leukocyte antigen (HLA) B27-positive cases of urogenital tuberculosis (TB) with asymmetric polyarthritis. Stained smears with Ehrlich Ziehl-Neelsen and polymerase chain reaction (PCR) tests for Mycobacterium tuberculosis complex (MTC) of the ejaculate were positive in both cases, despite negative cultures. Stained smear, culture and PCR results of the synovial fluid for mycobacteria were negative. The patients were diagnosed with Poncet's disease. Polyarthritis was resolved rapidly with anti-tuberculosis treatment. We suggest that in cases with unexplained arthritis and non-articular TB, Poncet's disease should be considered. PCR can be used in the routine diagnostic algorithm when conventional methods fail to identify MTC.

[The epidemiological and clinical aspects of extrapulmonary tuberculosis in children and adolescents in Primorsk Region]

The incidence of extrapulmonary tuberculosis has been studied in children and adolescents in the Primorye Territory in 1996 to 2001. There is a decrease in the incidence and prevalence of extrapulmonary tuberculosis in both children and adolescents, which does not reflect the true situation as the process is more frequently diagnosed on their referral in the period of late clinical manifestations. Young age children have fallen ill more frequently (54.7%); 76% of the patients were identified on their referral. Most children are permanent residents and live in the high- and middle-class families. In the clinical pattern, there were predominant ostcoarticular forms of tuberculosis running with a complication of the underlying disease in 80%. The study suggests that there are great gaps in the detection of extrapulmonary tuberculosis in children.

[Intravascular laser radiation of blood in the multimodality treatment of patients with urogenital tuberculosis]

Laser therapy was performed in 45 patients with tuberculosis of the urinary system and male genitals. The radiation was found to have a positive action on the patients' general condition and short-term immunomodulating effect. Following a month, immunological parameters became baseline or near-baseline. In the course of 5 years there was an exacerbation of tuberculosis in 2 (4 +/- 3%) patients who had received laser therapy and in 8-18% routinely treated without laser therapy.

[The osmolarity of the blood and urine in patients with tuberculosis of the urinary system and chronic kidney failure]

Osmolarity and its constituents were followed up during the treatment course in 43 patients with tuberculosis of the urinary system and in 14 controls. The authors confirmed the relation of the blood and urinary osmolarity to the stage of chronic renal failure (CRF). CRF aggravation was evidenced by the development of hypo-osmolarity in the urine and a progressing decrease in the ratio coefficient between the osmolarity in the urine and in the plasma. Stability of plasma hyperosmolarity continued to be more than 340 mosmol/kg H2O and a decrease in the aforementioned coefficient to less than 1 despite the treatment evidenced the terminal stage of CRF and unfavourable outcome of surgical intervention.