Purified protein derivative

Persons with acquired immunodefidency syndrome or those who are positive for the human immunodefidency virus and have a positive tuberculosis skin test or a negative tuberculosis skin test but a history of a prior significant reaction to purified protein derivative (a skin test for tuberculosis)... 

Because of the risks of adverse reaction to the vaccine by persons who had already been exposed to the disease a sensitivity test must be carried out prior to immunization with BCG. A Mantoux skin test assesses an individual s sensitivity to a purified protein derivative (PPD) prepared fi om heat-treated antigens (tuberculin) extracted fiom M tuberculosis. A positive test imphes past infection or past, successful immunization Those with strongly positive tests may have active disease and should be referred to a chest clinic. Many people with active TB, especially disseminated TB, however, sero-convert fiom skin test positive to skin test negative. Results of the skin test must therefore be interpreted with care. 

PPD Purified protein derivative PPME Polymeric polysaccharide rich in mannose-6-phosphate moieties PRA Percentage reactive activity PRD, PRDII Positive regulatory domain, -II PR3 Proteinase-3 PRBC Parasitized red blood cell proET-1 Proendothelin-1 PRL Prolactin PRP Platelet-rich plasma PS Phosphatidylserine P-selectin Platelet selectin formerly known as platelet adctivation-dependent granule external membrane protein (PADGEM), granule membrane protein of MW 140 kD (GMP-140)... 

TB skin testing with the 5-TU strength of brand purified protein derivative (PPD), also known as the Mantoux test, is the preferred method for skin testing.2,16,20 The product is injected into the skin (not subcutaneously) with a fine (27-gauge) needle and produces a small, raised, blanched wheal to be read by an experienced professional in 48 to 72 hours. Criteria for interpretation are listed in Table 72-1.1,2,6,16,20 The Centers for Disease Control and Prevention (CDC) does not recommend the routine use of... 

Purified protein derivative (PPD) Material used in the tuberculin skin test, the most common test for exposure to Mycobacterium tuberculosis. 

Del Prete, G., De, C.M., Mastromauro, C., Biagiotti, R., Macchia, D., Falagiani, P., Ricci, M. and Romagnani, S. (1991) Purified protein derivative of Mycobacterium tuberculosis and excretory-secretory antigen(s) of Toxocara cams expand human T cells with stable and opposite (type 1 T helper or type 2 T helper) profile of cytokine production. Journal of Clinical Investigation 88, 346-350. 

The most common carrier proteins in use today are keyhole limpet hemocyanin (KLH MW 4.5 X 105 to 1.3 X 107), BSA (MW 67,000), aminoethylated (or cationized) BSA (cBSA), thyroglobulin (MW 660,000), ovalbumin (OVA MW 43,000), and various toxoid proteins, including tetanus toxoid and diphtheria toxoid. Other proteins occasionally used include myoglobin, rabbit serum albumin, immunoglobulin molecules (particularly IgG) from bovine or mouse sera, tuberculin purified protein derivative, and synthetic polypeptides such as poly-L-lysine and poly-L-glutamic acid. 

A 35-year-old male has recently converted to positive on a purified protein derivative of tuberculin (PPD) test for TB. INH is given as prophylaxis. 

The most widely used screening method for tuberculous infection is the tuberculin skin test, which uses purified protein derivative (PPD). Populations most likely to benefit from skin testing are listed in Table 49-2. 

Delayed cutaneous hypersensitivity is commonly assessed using antigens to which the patient has been previously sensitized. The recall antigens used most frequently are mumps, Candida albicans, streptokinase-streptodornase, Trichophyton, coccidioidin, and purified protein derivative. Anergy is associated with malnutrition. 

Active tuberculosis Rifabutin prophylaxis must not be administered to patients with active tuberculosis. HIV-positive patients are likely to have a nonreactive purified protein derivative (PPD) despite active disease. Chest X-ray, sputum culture, blood culture, urine culture, or biopsy of a suspicious lymph node may be useful in the diagnosis of tuberculosis in the HIV-positive patient. 

Serious adverse events occur in up to 6% of patients with anti-TNF therapy. The most important adverse effect of these drugs is infection due to suppression of the ThI inflammatory response. This may lead to serious infections such as bacterial sepsis, tuberculosis, invasive fungal organisms, reactivation of hepatitis B, listeriosis, and other opportunistic infections. Reactivation of latent tuberculosis, with dissemination, has occurred. Before administering anti-TNF therapy, all patients must undergo purified protein derivative (PPD) testing prophylactic therapy for tuberculosis is warranted for patients with positive test results. More common but usually less serious infections include upper respiratory infections (sinusitis, bronchitis, and pneumonia) and cellulitis. The risk of serious infections is increased markedly in patients taking concomitant corticosteroids. 

PPD purified protein derivative PR by rectum Prep preparation PRG pregnancy... 

PPD-kit (tuberculin-purified protein derivative, Cambridge Research Biochemicals Ltd, Macclesfield, UK). 

Before administering infliximab, all patients must undergo purified protein derivative (PPD) testing prophylactic therapy for tuberculosis is warranted for patients with positive test results. Other infections include pneumonia, sepsis, pneumocystosis, and listeriosis. 

Synthetic peptide coupled to carrier such as KLH (Keyhole Limpet Hemocya-nin) or PPD (Purified Protein Derivative of tuberculin). 

Note The PPD is a purified protein derivative of Mycobacterium tuberculosis that is injected subcutaneously into the volar surface of the forearm to stimulate a hypersensitivity reaction. If, within 24 to 48 hours there is an area of induration greater than 10 mm in diameter, it is a positive PPD test and indicates that the patient had been exposed to and infected with Mycobacterium tuberculosis.] The patient s test was positive. Due to his homeless status, it is likely that he came in contact with TB-infected individuals. 

Therapy depends on etiology. In individuals who are suspected of having tuberculosis, diagnosis should make use of a purified protein derivative skin test, chest radiograph, and sputum cultures if necessary. These individuals should be referred for comanagement to their primary physician or to an infectious disease specialist. Though antituberculin agents are systemically administered, the ocular lesions are appropriately treated with topical steroids. In most instances, patients respond to 1% prednisolone acetate every 3 to 4 hours for the first day, subsequently tapered rapidly on the basis of the clinical response. 

ACE = angiotensin-converting enzyme ANA = antinuclear antibody ANCA = antineutrophil cytoplasmic antibody BUN = blood urea nitrogen CBC = complete blood count ELISA = enzyme-Mnked immunoassay assay ESR = erythrocyte sedimentation rate FTA-ABS = fluorescent treponemal antibody absorption HLA = human lymphocyte antigen MHA-TP = micro-hemagglutination-7re/ OMew pallidum-, PPD = purified protein derivative RPR = rapid plasma reagin VDRL = venereal disease reference laboratory. 

Tuberculosis QuantiFERON-TB Gold Chest Internist Purified protein derivative skin test... 

Purified protein derivative The purified protein derivative test for tuberculosis may be recommended in patients with chronic or granulomatous uveitis. Sterile tuberculin protein injected intradermally on the forearm produces induration at the site of inoculation if the patient is seropositive for tuberculosis. Purified protein derivative should be ordered when the physical... 

Fluorescent treponemal antibody absorption or microhemagglutination assay for Treponema pallidum Purified protein derivative and energy panel Chest radiograph for sarcoidosis and tuberculosis Lyme enzyme-linked immunosorbent assay HLA-B27 typing (possibly)... 

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