Late diagnosis and TCD8 immune response profile of cutaneous tuberculosis: A case report

Bruna Daniella de Souza Silva, Sueli Lemes de Ávila Alves, André Kipnis, Ana Paula Junqueira-Kipnis

Departamento de Microbiologia, Imunologia, Patologia e Parasitologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiania/GO, Brazil.
Laboratório Central de Saúde Pública Dr. Giovanni Cysneiros LACEN/GO; Goiania/GO, Brazil.

DOI: 10.4236/oji.2012.23015                

Abstract

Introduction: Cutaneous tuberculosis (CTB) is a rare form of extra-pulmonary tuberculosis that, when associated with late diagnosis, worsen the quality of life of the sick individuals. This report presents a case of late diagnosis of CTB. Unusual clinical manifestations retarded the correct tuberculosis diagnosis for more than a year. The immune response elicited by this type of tuberculosis as well as the factors that might contribute to the delay in diagnosis was evaluated and discussed. Methodology: Clinical evaluation and flow cytometric analyses of PBMC were realized for a case of CTB and a healthy individual as a control. Results: M. tuberculosis specific TCD8+ cell response was analyzed by flow cytometry and revealed positive cells for IL-17, IL-10, TGF-β and IDO. The CTB patient presented higher percentage of those cells when compared to a healthy donor. However, TCD8 cells positive for the important protective cytokine, IFN-γ was decreased in the CTB patient. Conclusion. The assessment of the M. tuberculosis specific TCD8+ immune response showed a regulatory/modulatory phenotype with a reduced IFN-γ response when compared to the healthy control that could have contributed to the CTB infection.

Keywords

Cutaneous tuberculosis; Late Diagnosis; CD8+ T Cells

Conflicts of Interest

The authors declare no conflicts of interest.

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