Kveim test
The Kveim test (also called "Nickerson Kveim-" or "Kveim-Siltzbach test") is a medical skin test for the diagnosis at Sarkoidoseverdacht was used. It was published in 1941 by the Oslo doctor Morten A. Kveim, but a similar test had already been described by Williams and Nickerson in 1935. The test is no longer used today and is therefore only of historical significance.
To produce the liquid test substance, spleen or lymph node tissue from sarcoid patients was required. This was ground, floated and heat-treated so that a sterile suspension was created. Manufacturers were American and Australian companies, as well as individual researchers, the uniformity of the test results being unsatisfactory due to the inconsistency of the test substances.
principle
Cell-containing material from sarcoid patients is able to trigger nodules typical of sarcoidosis in other patients. The active substance on which this reaction is based is not known.
execution
0.15 ml of the test substance are injected strictly intracutaneously (into the top layer of skin) on the palm side of the forearm . The injection site is marked. A tissue sample is taken from this after 3 to 6 weeks. This removal is essential, regardless of whether a typical 2 to 7 mm large, brownish-reddish skin lump has formed. The tissue is examined with a light or electron microscope for the characteristics of a sarcoid-like nodule ( granuloma ).
rating
Healthy people usually do not respond to the injection of the test substance. A false positive reaction can occur in up to 3% of the cases. Actually sarcoid sufferers - depending on the type of test material used, the stage and the location of the disease - test positive to 70 to 90%. A cortisone therapy weakens the skin reaction. After the sarcoid has healed, the body's willingness to react diminishes over the course of decades.
Problems
Since a test substance was hardly available and had not been available at all since the mid-1990s, the Kveim test was no longer used. It could also not be ruled out that the injection of the human test material could cause an infection with bovine spongiform encephalopathy (BSE) ("mad cow disease"). In addition, the pre-testing of the material on sick and healthy people to ensure sufficient effectiveness was time-consuming, the test duration of several weeks was problematic and the need for a small surgical procedure (skin tissue removal) was a burden. There was also the improvement of alternative diagnostic methods. Therefore, since the early 1970s, there has been increasing criticism in the scientific literature, so that the test has been put out of use.
Alternative methods of investigation
Lung tissue collection by means of bronchial mirroring ( bronchoscopy ) or mediastinoscopy and microscopic examination.
Literature and web links
- D. Böttger: Sarcoid - Theory and Practice; Leipzig 1982
- E. Braunwald et al .: Harrison - Principles of Internal Medicine; Basel 1989
- Kveim, A .: En ny og spesifikk kutan-reaksjon ved Boecks sarkoid, Nord. Med. 9 (1941) 169
- The Kveim test. In: British medical journal. Volume 2, number 5762, June 1971, p. 604, PMID 5580717 , PMC 1796475 (free full text).
Individual evidence
- ^ The Kveim-controversy, Lancet II (1971) 750
