Brief communication

Unusual pathological condition in the lower extremities of a skeleton from ancient Israel

Bibliographic Data

ID8314794
AuthorsMark Spigelman (University College London), Helen D Donoghue (0000-0003-3918-5252, University College London)
Year2001
Volume114
Issue1
Pages92-93
Publication date2001-01-01
Open AccessYes
TypeARTICLE
VenueAmerican Journal of Physical Anthropology (JOURNAL)
Journal identifiersISSN: 0002-9483 • E-ISSN: 1096-8644
PublisherWiley (PUBLISHER • GB)
DOI10.1002/1096-8644(200101)114:1<92::aid-ajpa1008>3.0.co;2-v
PMID11150055
OpenAlexW2039059074
LanguageEN
Citations received10
References cited6

Hershkovitz et al. (1992) reported on a skeleton from Bet Guvrin, Israel, dating from the Byzantine period (300-600 AD).There were pathological changes in the lower extremities, which presented significant diagnostic problems.Their original diagnosis was Madura foot, based on the absence of typical medullary changes associated with osteomyelitis, and to the presence of severely ankylosed (left calcaneal talar joint) and deformed bilateral foot bones.However, Manchester (1993), in reply, noted that Madura foot is usually a predominantly unilateral condition, and that many of the surface changes were consistent with secondary pyogenic infections following plantar ulceration associated with leprous peripheral neuropathy.There was evidence that at least one joint was a typical Charcot's joint suggestive of the presence of some form of neuropathy.Manchester (1993) noted that this skeleton was from the same period as one reported by Zias (1985), which was the first ancient skeleton from which Mycobacterium leprae DNA was extracted and amplified (Rafi et al., 1994).In further reply, Hershkovitz et al. (1993) admitted that the pathological features could fit a diagnosis both Madura foot and leprosy, but still considered Madura foot the more likely.Here the controversy rested.As the controversy has remained unresolved, one of the bones from the foot was sent to us by Professor Israel Hershkovitz of the Department of Anatomy and Anthropology, Tel Aviv University, Israel, for further examination.The aim was to determine whether M.leprae DNA was present in this specimen, as mycobacterial DNA has been shown to persist in samples of a similar age (Rafi et al. 1994;Donoghue et al. 1998).Even in the case of lepromatous leprosy, the numbers of bacilli in peripheral sites are not believed to be high.Therefore, the specimen was examined using a specific nested polymerase chain reaction (PCR), to determine whether M.leprae -specific DNA could be detected.Two sets of M.leprae -specific nested primers were designed.The first were based on the M. leprae repetitive element RLEP, which is reported to be present at 28 copies/cell.These gave an outer product of 129 bp and a 99 bp-nested product.Those based on the 18kD antigen (Ag) gene gave a product of 136 bp (outer) and 110 bp (inner).The sequences and locations of these primers are listed in Table 1.

Pathological · Pathology · Skeleton (computer programming) · Anatomy · Infectious Diseases and Tuberculosis · Medicine · Mycobacterium research and diagnosis · Yersinia bacterium, plague, ectoparasites research

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