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What is the diagnosis for lesions in frontal right and left temporal lobe?

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General & Family Physician
Practicing since : 2003
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After doing blood immunology test we have received the result as follows

Anti TB- IgM 3.23unit
Anti TB- IgA <200
Anti TB- IgG<200

What does the result indicate and what is the future course of action
Posted Thu, 3 May 2012 in Brain and Spine
Follow-up: What is the diagnosis for lesions in frontal right and left temporal lobe? 20 minutes later
small lesions in right frontal right paracentral left temporal lobe left cerebellar hemisphere with minimal surrounding edema. Central portion of the lesion show non diffusion restricting T2 hyperintense lession (abcess less likely)
Spectroscopy of the central aspect of the lesion show increased lipid/lactate peak, no significant enlarged choline peak
 
 
Answered by Dr. Deepak Anvekar 4 hours later
Hello XXXXXXX

From the description it lesions in the brain described on the scans are likely to be tuberculoma.

It indicates that you have undergone Mycobacterium tuberculosis (TB) ELISA IgG, IgM, IgA Assay test designed for the presumptive qualitative detection of IgG, IgM and IgA antibodies to TB in human serum and for the presumptive diagnosis of acute, recent, or reactive TB infection. In your case the serology assays for tuberculosis are positive for IgM antibodies and Negative for IgA and IgG antibodies. This is a indicator of a recent or active Tuberculosis infection.

The report of the scan mentioned is probably indicative of granulomatous inflammatory lesions in the cerebellum associated with edema due to inflammation and hence are suggestive of tuberculomas (Findings suggestive of TB).

You might consult with your treating doctors who can perform a Lumbar puncture and a CSF analysis, which can give confirmation of the diagnosis.

Once the diagnosis is confirmed, anti-tubercular treatment with multidrug regimen can be initiated for a period of 9 -12 months. This might help to treat and clear the infection. Though it may seem difficult for such a long duration of treatment, it is neccessary step to prevent reactivation of TB and worsening of the neurological status.

I hope this helps to answer your questions. If you have any doubts, you can forward them to me, and I shall be glad to answer them for you.

Regards.

Dr Anvekar.
Above answer was peer-reviewed by
 
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