Utility of PCR in the Diagnosis of Female Genital Tuberculosis

Yıl 2014, , - , 01.06.2014

Manmeet Kaur Gill Aruna Aggarwal

https://doi.org/10.5799/ahinjs.02.2014.02.0131

Öz

Genital tuberculosis (GTB) is one of the major causes of infertility among females. Since the infection is asymptomatic in most of the cases, it makes the clinical diagnosis quite difficult. We report a case of a 24 years old female with infertility that was discovered to have endometrial tuberculosis, detected by PCR using IS6110. The culture report was negative and histopathological examination indecisive. She was given anti-TB therapy and subsequently had a pregnancy with a live birth. Although conventional methods like culture on Lowenstein-Jensen medium and histopathology are important in the diagnosis of such cases but the molecular methods like PCR can be a highly useful aid in the establishment of a rapid and early diagnosis of genital and other forms of extra-pulmonary tuberculosis.

Anahtar Kelimeler

Genital tuberculosis, Mycobacterium tuberculosis, nested polymerase chain reaction, IS6110 sequence.

Utility of PCR in the Diagnosis of Female Genital Tuberculosis

Öz

Genital tüberküloz (GTB) kadınlarda kısırlığın en önemli nedenlerinden biridir. GTB’nin klinik tanısı, olguların çoğunun asemptomatik veya çok farklı klinik görünümlerde olması nedeniyle, zordur. Biz 24 yaşında, PCR’da IS6110 probu kullanılarak endometrial tüberküloz tanısı konulan, infertil bir kadın hastayı sunduk. Hastanın kültür sonuçları negatifti ve histopatolojik incelemesi tanı koydurmuyordu. Hastaya antitüberküloz tedavi verildi ve ardından hamile kalarak canlı bir bebek doğurdu. Lowenstein-Jensen besiyerinde kültür ve histopatoloji gibi geleneksel yöntemler bu gibi olguların tanısında oldukça önemlidir; ancak PCR gibi moleküler metotlar, genital tüberküloz ve diğer akciğer dışı tüberküloz olgularında hızlı ve erken tanı koymada çok faydalı olabilmektedirler

Anahtar Kelimeler

Genital tüberküloz, Mycobacterium tuberculosis, nested polimeraz zincir reaksiyonu, IS6110 sekansı

Kaynakça

• Jahromi BN, Parsanezhad ME, Ghane-Shirazi R. Female genital tuberculosis and infertility. Int. J Gynaecol Obstet 2001;75:269-272.
• Deepjyoti VG, Kiran M, Neera A, Sunil G. Isolation of myco- bacteria from cases of infertility in women. J Obstet Gynae- col India 1990;40:803-805.
• Deshmukh K, Lopez J, Naidu AK, et al. Place of laparoscopy in pelvic tuberculosis in infertile women. J Obstet Gynaecol India 1987;37:289-291.
• Eisenach KD, Cave MD, Bates JH, Craford JT. Polymerase chain reaction amplification of a repetitive DNA sequence specific for M. tuberculosis. J Infect Dis 1990;161:977-981.
• Gatongi DK, Gitau G, Kay V, et al. Female genital tract tuber- culosis. J Obstet Gynaecol 2005;7:75–79.
• Bhanu NV, Singh UB, Chakraborty M, et al. Improved diagnos- tic value of PCR in the diagnosis of female genital tract tu- berculosis leading to infertility. J Med Microbiol 2005;54:927– 931.
• Kumar P, Shah NP, Singhal A, et al. Association of tubercu- lar endometritis with infertility and other gynecological com- plaints of women in India. J Clin Microbiol 2008;46:4068– 4070.
• Thangappah RBP, Paramasivan CN, NarayananS. Evaluat- ing PCR, culture & histopathology in the diagnosis of female genital tuberculosis. Indian J Med Res 2011;134: 40-46.
• Narayanan S, Parandaman V, Narayanan PR, et al. Evalua- tion of PCR using TRC(4), and IS6110 primers in detection of tuberculous meningitis. J Clin Microbiol 2001;39:2006-2008.
• Jindal UN, Verma S, Bala Y. Favourable infertility outcomes following anti-tubercular treatment prescribed on the sole ba- sis of a positive polymerase chain reaction test for endome- trial tuberculosis. Hum Reprod 2012;27:1368-1374.
• Chauhan DS1, Sharma VD, Parashar D, et al. Molecular typing of Mycobacterium tuberculosis isolates from different parts of India based on IS6110 element polymorphism using RFLP analysis. Indian J Med Res 2007;125:577-581.