title: Unusual spinal tuberculosis in an Avar Age skeleton (Csongrád-Felgyő, Ürmös-tanya, Hungary): A morphological and biomolecular study.
abstract: The paleopathological analysis of a well-preserved young adult female skeleton from the AD 7-8th century (Avar Age) in Hungary revealed multiple lytic lesions in all of the thoracic and lumbar vertebral bodies. The lesions were characterized by smooth marginal zones and space-occupying mass appearance. The considerable loss of spongy bone in the thoracolumbar vertebrae resulted in angular deformity and fusion, characteristic of the healing stage of TB. Osteolytic lesions were also observed on the vertebral processes, ribs and sternum. On the endocranial surface, abnormal blood vessel impressions were revealed, indicating some kind of meningitis. The X-ray and CT analysis of the affected bones detected abnormal structures and cystic zones of destruction. The lesions were however not always bordered by areas of increased density, which is typical in cystic TB. Vertebral remains were also subjected to biomolecular analysis in two different laboratories, which attested the presence of Mycobacterium tuberculosis complex (MTBC) DNA and supported the paleopathological diagnosis of TB. Spoligotyping analysis confirmed the presence of MTBC DNA and more specifically an infection caused by bacteria belonging to the M. tuberculosis lineage. This case study provides new data for the paleoepidemiology of TB in this geographical area and historical period, and draws attention to the great variability of TB lesions in the human skeleton.
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary. Electronic address: palfigy@bio.u-szeged.hu.
authors.forename: G
authors.initials: G
authors.lastname: Pálfi
authors.affiliation: Institute for Mummies and the Iceman, EURAC European Academy, Bolzano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Maixner
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: M
authors.initials: M
authors.lastname: Maczel
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: E
authors.initials: E
authors.lastname: Molnár
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Pósa
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: L A
authors.initials: LA
authors.lastname: Kristóf
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Marcsik
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: J
authors.initials: J
authors.lastname: Balázs
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary.
authors.forename: M
authors.initials: M
authors.lastname: Masson
authors.affiliation: Department of Biological Anthropology, University of Szeged, Hungary; National Heritage Protection Centre, Hungarian National Museum, Szeged, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Paja
authors.affiliation: Department of Radiology, University of Szeged, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Palkó
authors.affiliation: Privatklinik Döbling, Department of Diagnostic Imaging and Interventional Radiology, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Szentgyörgyi
authors.affiliation: Institute of Pathology, Academic Hospital Munich-Bogenhausen, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Nerlich
authors.affiliation: Institute for Mummies and the Iceman, EURAC European Academy, Bolzano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zink
authors.affiliation: Laboratoire d'anthropologie biologique Paul Broca de l'EPHE (Ecole Pratique des Hautes Etudes), UMR 5199 PACEA, Université de Bordeaux, Pessac, France; Department of Anthropology, University of Western Ontario, Canada.
authors.forename: O
authors.initials: O
authors.lastname: Dutour
mesh_terms: D000328:Adult; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D049690:History, Ancient; D006801:Humans; D006814:Hungary; D009169:Mycobacterium tuberculosis / Q000235:genetics; D021141:Nucleic Acid Amplification Techniques; D010164:Paleopathology; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000235:genetics / Q000266:history / Q000473:pathology*; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
keywords: Biomolecular study; Endocranial alterations; Multiple lytic lesions; Mycobacterium tuberculosis; Paleopathology; Spinal TB