METHOD FOR IMMUNODIAGNOSTICS OF TUBERCULOSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE Russian patent published in 2022 - IPC G01N33/53 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to phthisiology, and can be used for comprehensive immunodiagnostics of tuberculosis in patients with terminal chronic kidney disease (CKD). Patients in the terminal stage are given a tuberculin Mantoux test with 2 TU of PPD-L; after 72 hours, the response to the tuberculin Mantoux test with 2 TU of PPD-L is determined, and either a negative response is recorded if infiltration and hyperaemia are absent, or an intermediate response if infiltration with a diameter of 2 to 4 mm or only hyperaemia of any size are present, or a positive response if infiltration with a diameter of 5 mm or more is present, or a sharply positive response if infiltration with a diameter of 21 mm or more is present, or if vesicles, lymphangitis or regional lymphadenitis are present regardless of the size of infiltration. Simultaneously, on the day of the Mantoux test with 2 TU of PPD-L, a skin test is performed on another area of the skin with the recombinant tuberculosis allergen Diaskintest. After 72 hours, simultaneously with determining the response to the tuberculin Mantoux test with 2 TU of PPD-L, the response to the skin test with the recombinant tuberculosis allergen Diaskintest is determined, and either a negative response is recorded if no trace is present or a spot mark or bruise up to 2 mm is present, or an intermediate response is hyperaemia of any size is present, or a positive response if a papule of any size is present. Joint assessment of the results of response to the Mantoux test with 2 TU of PPD-L and the results of response to the skin test with the recombinant tuberculosis allergen Diaskintest is performed, wherein patients with negative response to both tests are diagnosed with anergy caused by an immunodeficiency condition, and in the event of positive response to at least one of the test, the patient is diagnosed with active tuberculosis. Herewith, a skin area on the inner surface of the middle third of the forearm of both arms, a skin area on the inner surface of the middle third of the forearm of one arm and a skin area on the front surface of the thigh in case of AV fistula in patients receiving renal replacement therapy via haemodialysis are used as the other skin area for the skin test with the recombinant tuberculosis allergen Diaskintest.

EFFECT: high sensitivity and accuracy of the test due to the application of both samples simultaneously in the event of impossibility of taking the QuantiFERON®TB Gold In-Tube test when diagnosing tuberculosis in this category of immunodeficient patients.

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