[Clinico-immunological studies of pulmonary tuberculosis in the elderly]

We studied tuberculin reactivity and clinical course after starting chemotherapy in patients with active pulmonary tuberculosis divided by four age-groups less than 29, 30-49, 50-69 and 70 years and more. The skin test to tuberculin purified protein derivative (PPD) was examined in 178 cases of active pulmonary tuberculosis, 120 cases of lung cancer, 25 cases of atypical mycobacteriosis and 466 cases of the other respiratory diseases. The average size of tuberculin reaction in pulmonary tuberculosis decreased with age, but significantly higher than that in patients with other nontuberculous pulmonary diseases of the same age-group. The size of PPD skin test in the group of 70 years and more was significantly lower than other age-groups in pulmonary tuberculosis. We compared the time required for negative conversion of sputum by culture after primary chemotherapy among the different age-groups in pulmonary tuberculosis. It revealed that the time for negative conversion tended to be longer with age, and the time in the group 70 years and more was significantly longer than that of the group less than 29 years of age, although no significant differences in the radiographic severity and conditions of chemotherapy were observed. Finally, the PPD-induced lymphocyte proliferation test in vitro was done in newly diagnosed patients with pulmonary tuberculosis. The patients were divided into two groups by the size of PPD skin test (high responder more than 16 mm and low responder less than 15 mm of erythema induced by PPD).(ABSTRACT TRUNCATED AT 250 WORDS)