Montecalvo M A, Wormser G P
Department of Medicine, New York Medical College, Valhalla.
Mt Sinai J Med. 1994 Sep;61(4):363-5.
Because of the human immunodeficiency virus epidemic, skin testing for Mycobacterium tuberculosis is now performed in conjunction with control skin tests to assess anergy and thus provide information to aid in the interpretation of a negative tuberculin test. However, anergy can occur selectively to purified protein derivative tuberculin when reactions to other recall antigens are present. We report an illustrative case of selective anergy in a patient with tuberculous meningitis and review the literature on this poorly understood phenomenon. When one suspects M. tuberculosis disease, repeating a 5 unit PPD-tuberculin skin test after four to eight weeks of antituberculous treatment may assist in establishing or excluding the diagnosis of tuberculosis.
由于人类免疫缺陷病毒流行，目前在进行结核分枝杆菌皮肤试验时会同时进行对照皮肤试验，以评估无反应性，从而为解释结核菌素试验阴性提供辅助信息。然而，当对其他回忆抗原存在反应时，可能会选择性地出现对纯化蛋白衍生物结核菌素无反应的情况。我们报告了一例结核性脑膜炎患者发生选择性无反应的典型病例，并回顾了关于这一了解甚少的现象的文献。当怀疑患有结核分枝杆菌病时，在抗结核治疗四至八周后重复进行5单位PPD - 结核菌素皮肤试验可能有助于确立或排除结核病的诊断。
