Background

The remains of a 3-5 year-old child from the late mediaeval cemetery serving the Priory of St. Peter and St. Paul, Taunton, Somerset, UK was the subject of an aDNA study.

Objective

The aim was to distinguish between two differential diagnoses suggested by earlier osteological examination of the remains; either tuberculosis or Langerhans cell histiocytosis.

Findings

The remains tested positive for MTB complex markers, corroborating this diagnosis reached on osteological grounds. Based on positivity for the mtp40 element and a deletion in the pks15/1 locus, we conclude that infection was due to a strain of the human pathogen M. tuberculosis belonging to lineage 4. Although DNA recovered from the case was heavily fragmented, sex determination by amelogenin PCR suggested these are the remains of a young male child. The findings are discussed considering additions to the literature since the original report.

Conclusions

Descriptions of tuberculosis in children from this period are rare and burial Sk2077 represents the first UK example of a pre-adolescent individual to have a molecular diagnosis combined with osteological pathology. This provides an important reference of childhood tuberculosis and insight into the likely presence of tuberculosis in the mediaeval adult population served by this cemetery.

中文翻译：

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英格兰中世纪晚期萨默塞特一例儿童结核病

背景

来自英国萨默塞特郡汤顿的圣彼得和圣保罗修道院服务的中世纪晚期墓地的一名 3-5 岁儿童的遗体是 aDNA 研究的主题。

客观的

目的是区分早期对遗骸进行骨科检查提出的两种鉴别诊断；结核病或朗格汉斯细胞组织细胞增多症。

发现

遗骸对 MTB 复合标记物检测呈阳性，证实了在骨学基础上得出的这一诊断。基于阳性为mtp40元件，并在缺失pks15 / 1基因座中，我们得出结论，感染是由于人类病原体的菌株M. 结核属于谱系4 。尽管从案件中回收的 DNA 非常碎片化，但通过牙釉蛋白 PCR 确定的性别表明这些是一名年轻男孩的遗骸。考虑到自原始报告以来对文献的补充，讨论了这些发现。

结论

这一时期对儿童结核病的描述很少见，埋葬的 Sk2077 代表了英国第一个将分子诊断与骨病理学相结合的青春期前个体的例子。这为儿童结核病提供了重要参考，并深入了解该墓地服务的中世纪成年人口中可能存在结核病。