Mycobacterial DNA in recurrent sarcoidosis in the transplanted lung - A PCR-based study on four cases

Huberta Klemen, Aliya N. Husain, Philip T. Cagle, Edward R. Garrity, Helmut H. Popper

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Sarcoidosis is a systemic granulomatous inflammation, which may be caused by mycobacteria other than M. tuberculosis complex (MOTT) in one-third of cases. A few cases of recurrent sarcoidosis in the transplanted lung have been reported. However, mycobacteria have been excluded by acid-fast stains only. We investigated four cases of recurrent sarcoidosis in lung transplant patients. Using PCR for the insertion sequence 6110 of Mycobacterium turberculosis complex and a second PCR for the mycobacterial chaperonin (65-kDa antigen coding sequence), we looked for mycobacterial DNA. In three cases sequence analysis was also performed. One patient was negative for mycobacterial DNA in explanted, but positive for M. tuberculosis DNA in transplanted lung, qualifying this case as M. tuberculosis infection in the transplant. Three patients were negative for M. tuberculosis DNA, but were positive for MOTT-DNA in both explanted and transplanted lungs. In these three patients sequence identity of the amplified sequences before and after transplantation was proven, which rules out mycobacteriosis. Recurrent sarcoidosis does occur, but can only be proven by the exclusion of mycobacterial DNA. In cases of recurrent MOTT-DNA-positive sarcoidosis the diagnosis cannot be confirmed except by proof of sequence identity. Probably MOTT-DNA-positive sarcoidosis is more likely to recur in a transplanted lung.

Original languageEnglish (US)
Pages (from-to)365-369
Number of pages5
JournalVirchows Archiv
Volume436
Issue number4
DOIs
StatePublished - Jan 1 2000

Keywords

  • Mycobacterial DNA
  • Recurrent sarcoidosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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