Virchows Archiv

, Volume 436, Issue 4, pp 365–369

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

  • H. Klemen
  • A. N. Husain
  • P. T. Cagle
  • E. R. Garrity
  • H. H. Popper
Original Article

DOI: 10.1007/s004280050460

Cite this article as:
Klemen, H., Husain, A., Cagle, P. et al. Virchows Archiv (2000) 436: 365. doi:10.1007/s004280050460

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 tuberculosis 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.

Key words Recurrent sarcoidosisMycobacterial DNA

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • H. Klemen
    • 1
  • A. N. Husain
    • 2
  • P. T. Cagle
    • 4
  • E. R. Garrity
    • 3
  • H. H. Popper
    • 1
  1. 1.Institute of Pathology, Karl-Franzens University of Graz, AustriaAT
  2. 2.Institute of Pathology, Loyola University of Chicago, Chicago, Illinois, USAUS
  3. 3.Department of Medicine, Loyola University of Chicago, Chicago, Illinois, USAUS
  4. 4.Baylor Medical College, Houston, Texas, USAUS
  5. 5.Institute of Pathology, Laboratory for Respiratory and Environmental Pathology, Auenbruggerplatz 25, Graz, A-8036, Austria e-mail: popper@email.kfunigraz.ac.at Tel.: +43-316-3804405, Fax: +43-316-3809636AT