Value of polymerase chain reaction in patients with presumptively diagnosed and treated as tuberculous pericardial effusion | [Pakistan Heart Journal • 2012]

Author(s):

1. Hafiz ur Rehman: Department of Cardiology, Saidu Teaching Hospital, Swat , Pakistan

2. Mohammad Hafizullah: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

3. Syed Tahir Shah: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

4. Sher Bahadar Khan: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

5. Abdul Hadi: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

6. Farooq Ahmad: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

7. Ibrahim Shah: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

8. Adnan Mehmood Gul: Department of Cardiology, Lady Reading Hospital & Khyber Medical University, Peshawar , Pakistan

Abstract:

Objective: To know the sensitivity of polymerase chain reaction (PCR) in pericardial fluid and response to antituberculous treatment (ATT) in PCR positive patients who were presumptively diagnosed and treated as tuberculous pericardial effusion. Methodology: This was a descriptive cross sectional study carried out from1stJune 2009 to 31th May 2010 at Cardiology Department, Lady Reading Hospital, Peshawar. Patients with presumptive diagnosis and receiving treatment for tuberculous pericardial effusion were included. Pericardial fluid sample was aspirated under fluoroscopy for the routine work up. The specimens were subjected to PCR detection of mycobacterium tuberculous DNA. Results: During 12 month study period, a total of 54 patients with large pericardial effusion presented to Cardiology department, Lady Reading Hospital, Peshawar. Of them, 46 patients fulfilled the criteria for presumptive diagnosis of tuberculous pericardial effusion. PCR for mycobacterium tuberculous DNA in pericardial fluid was positive in 45.7%(21).Patients were followed for three months. In PCR positive group, 01 patient while in PCR negative group 3 patients were lost to follow up. Among PCR positive patients 17(85%) while in PCR negative group 11(47.82%) patient responded to ATT both clinically and echocardiographically. We found that patients who were PCR positive responded better to therapy than those who were PCR negative and this finding was statistically significant (p=0.035). Conclusion: PCR, with all its limitations, is potentially a useful diagnostic test in patients with presumptively diagnosed tuberculous pericardial effusion. A PCR positive patient responds better to therapy as compared to PCR negative patient.

Page(s): 97-103

DOI: DOI not available

Published: Journal: Pakistan Heart Journal, Volume: 45, Issue: 2, Year: 2012

Keywords:

Tuberculosis , Polymerase chain reaction , Mycobacterium tuberculosis , Pericardial effusion , Pericardiocentesis

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