Faculty of Medicine

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    COMPLICATED TUBERCULOSIS IN A 13-YEAR-OLD CHILD WITH DOWN SYNDROME: A CASE REPORT
    (Macedonian Association of Anatomists and Morphologists, 2023-11-05)
    Nestorov, Hristijan
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    Doksimovski, Filip
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    Chakalaroska, Irena
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    Ivanovska, Julija
    Tuberculosis (TB) is the most common cause of infectious disease-related mortality worldwide. Most persons infected won’t develop active disease, but in certain instances such as extremes of age or defects in cell-mediated immune response, TB may develop. Down syndrome (DS) is the most common neurodevelopmental disorder of know genetic causeand described simply as arising from an extra copy of chromosome 21, presenting with characteristic features. Due to immune defects, DS suffer more frequently from respiratory tract infections than normal children.We present a case of a 13yearsold child with Down Syndrome who was diagnosed with lung tuberculosis, after a right sided lobectomy due to a lung abscess.The child was hospitalized, following a period of one and a half month with fever and vomiting that did not improve with therapy. Investigations were made, including CT scan on the lungs. Due to right sided empyema and abscess on the right upper lobe, right sided lobectomy was preformed. The postsurgical pathohistological findings were in addition to pulmonary tuberculosis. Four drug antituberculosis regimenwas started. The four-drugcourse was given for two months, and then a two-drugregime was continued. To this day the child is on the sixth month of the two-drugantituberculosis regime. CT scans, regular Chest X-rays and ultrasoundof the lungs were made, with gradual improvement.In Down syndrome patients who have a complicated pneumonia that doesn’t respond to standard treatment, a tuberculosis disease should be considered.
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    Scrofuloderma- a rare but serious diagnostic challenge
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2024-04)
    Mitreski, Vladimir
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    Zejnel, Sead
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    Shurbevska, Biljana
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    Stojkovska J., Aleksandra
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    Primary cavitating tuberculosis in an 8-month-old infant
    (European Society of Paediatric Radiology, 2023)
    Ognenoska, Biljana
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    Comparison od IFN-γ levels in children with tuberculosis desease(TB) and latent tuberculosis infection (LTBI).
    (ID Design Press,Skopje, Republic of Macedonia, 2018-11-25)
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    Simonovska, Liljana
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    Dilberovska, Mirjana
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    Dacevski, Dragan
    AIM: This study aimed to evaluate the importance of IFN-γ in the diagnosis of pediatric TB and LTBI and to compare the IFN-γ levels. METHODS: We analysed 100 patients examined for possible M. tuberculosis infection or disease at the Institute of Respiratory Diseases in Children, Kozle, Skopje. Patients were divided into 2 groups: TB disease and LTBI. The following parameters were analyzed: demographic characteristics, history of previous exposure to active TB, BCG vaccination and presence of BCG scar, lung X-ray findings, tuberculin skin test by the Monteux method and the value of INF-γ according to the Quantiferon TB gold test, direct samples of acid-alcohol-resistant bacilli of sputum and Löwenstein Jensen cultures. Informed parental consent was obtained for each child included in the study. RESULTS: In the LTBI group 60.9% had a scar from the vaccination while in the TB group 50% had BCG scar. TST induration diameters in children with or without BCG scar were significantly larger in patients with active TB. Children with active TB had significantly higher IFN-γ levels than children with LTBI. The IFN-γ for the cut-off of 0.35 IU/ml, has 64% sensitivity for detection of LTBI, versus 80.6% sensitivity for active disease. Children with close TB contact had significantly higher IFN-γ levels. Correlation between TST induration diameter and IFN-γ levels was stronger in the TB group. CONCLUSION: IFN-γ levels are significantly higher in children with active TB, and children with close contact with TB patient. It has better sensitivity in active TB. Using both tests (IFN-γ and TST) can improve the diagnose of LTBI and TB in countries where vaccination with BCG is widespread.