258 A Novel Therapeutical Option in Resistant Ganglionar and Cutaneous Tuberculosis

BACKGROUND: Transfer factor was first described in 1955 and constitutes a Dialyzable Leukocyte Extract. It has been widely used in several infectious diseases and malignancies with satisfactory results. Although not yet fully clarified, among the mechanisms of action the most accepted is the enhancement of the cellular immunity. METHODS: We tested transfer factor in a 1 year old and 3 months patient diagnosed with Ganglionar Tuberculosis. 1 week after the administrarion of the Bacillus Calmette-Guérin vaccination, the present developed fever, cervical, submandibular, supraclavicular, inguinal and axillary lymphadenopathy. Later on the patient devoloped cutaneous clinical manifestations of tuberculosis such as scrofuloderma, fistulas, hypertrophic scars and ultimately, queloids. The patient had previously undergone short-term strictly supervised treatment for tuberculosis with very poor results. When the treatment was first administered, the patient had the following data: Total White Blood Count 12.9 Lymphocytes: 29% (12–46) CD3: 26.3% (59–90) T helper Cells (CD3/CD4) 21.6% (42–58) Cytotoxic T cells (CD3/CD8) 5.1% (17–33) Natural Killer Cells (CD56) 2.1% (3–7) B cells (CD19) 67.6 % (0–10). RESULTS: At the end of the treatment, the patient´s immune system was enhanced in terms of cell count and improval of skin manifestations. Total White Blood Count 6.5 Lymphocytes: 51.3% CD3: 48.5% T helper cells (CD3/CD4) 31.2% Cytotoxic T Cells (CD3/CD8) 14.6% Natural Killer cells (CD56) 12.2% B cells (CD19) 985%. Cicatrization process was improved, with involution of skin lesions os scrofuloderma and fistulas. Lymphadenopathy was no longer encountered. We have followed the patient for a year and half and no relapses have been encountered. CONCLUSIONS: We consider Transfer Factor a valuable option as adyuvant therapy in cases of ganglionar and cutaneous tuberculosis refractory to conventional treatments. To our knowledge, this is the first report of a case of the disease treated satisfactorily with transfer factor.