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Ophthalmic Presentation of Disseminated Tuberculosis with Relapse-Immunological Profile

Authors
  • Kashyap, Bineeta1
  • Goyal, Nisha1
  • Das, G. K.2
  • P Singh, N.1
  • Kaur, I. R.1
  • 1 University College of Medical Sciences (UCMS) and Guru Teg Bahadur (GTB) Hospital, Department of Microbiology, Delhi, India , Delhi (India)
  • 2 University College of Medical Sciences (UCMS) and Guru Teg Bahadur (GTB) Hospital, Department of Ophthalmology, Delhi, India , Delhi (India)
Type
Published Article
Journal
Indian Journal of Clinical Biochemistry
Publisher
Springer India
Publication Date
Feb 21, 2018
Volume
33
Issue
4
Pages
483–486
Identifiers
DOI: 10.1007/s12291-018-0741-2
Source
Springer Nature
Keywords
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Abstract

TB as the cause of uveitis varies from 0.5 to 10.5%; low sensitivity of confirmatory laboratory investigations and inconsistency of diagnostic criteria leads to paucity of data. Diagnosis requires a high level of suspicion and is often presumptive based on indirect evidences. Interferon gamma, Interleukin-2 and Neopterin are key biomarkers in immuno-regulation of Mycobacterium tuberculosis infection. The relative shift from Interleukin-2 towards Interferon gamma (Interferon gamma/Interleukin-2) is more discriminatory for active tuberculosis. Protein carbonyl and Malondialdehyde, as oxidative stress markers, characterize active tuberculosis. A case of disseminated TB presenting with acute uveitis had a recurrent tubercular lymphadenitis after completing category I treatment under revised national tuberculosis control programme. The present study evaluates the potential utility of above mentioned biomarkers to predict atypical presentation in difficult cases of tuberculosis. Though tuberculous uveitis is amenable to treatment in early course of disease, the delay in diagnosis can have serious consequences for the patient.

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