Tuberculosis in Dr. Granville’s mummy

Source: Donoghue HD, Lee OY, Minnikin DE, Besra GS, Taylor JH, Spigelman M.

Tuberculosis in Dr Granville's mummy: a molecular re-examination of the earliest

known Egyptian mummy to be scientifically examined and given a medical diagnosis.

Proc Biol Sci. 2010 Jan 7;277(1678):51-6.

 

As soon as I read the title of this interesting article, I knew that I need to write a blog on it. Luckily the full text of the paper was also available online. This work is a collaborative effort of well known researchers from Centre for Infectious Diseases, University College, London, School of Bioscience, University of Birmingham, Department of Ancient Egypt and Sudan, The British Museum, London and Kuvin Centre for Study of Infectious and Tropical Diseases, The Hebrew University, Israel.

Dr. Augustus Bozzi Granville was an eminent physician and obstetrician who examined an Egyptian mummy by scientific autopsy in 1825. The mummy was of a 50 year old woman named, lady Irtyersenu. She was from necropolis of Thebes, of the 26^th Dynasty dated to 600BC. After detailed observation of the wrappings and the exterior features of the mummy, Granville decided to perform a detailed autopsy. This mummy is commonly called as Granville's mummy. Granville observed a mass around the right ovary, which was described by him as ovarian dropsy or cancer and he proposed that this was the cause of her death. Recent studies have however, shown that this was actually a benign cystadenoma of the ovary, which is described as non-fatal. Other studies carried out recently mentioned the presence of a pulmonary exudate, which can be a potentially fatal pathological condition. Many studies were carried out to determine the exact cause of death of the mummy. During the early 1990s, several attempts were made to detect microbial or human DNA from the Granville mummy by PCR. But these studies were not successful.

Based on paleopathological changes, tuberculosis has long been recognized in Egyptian mummies. Furthermore, M. tuberculosis complex DNA has been detected and characterized from the predynastic era, the Old, Middle and New kingdoms. Thus, authors of this paper sought to determine whether lady Istyersenu had tuberculosis, which might have been the cause of her death. For this they used two strategies. These were detection of M. tuberculosis by PCR and direct detection of specific cell wall mycolic acid biomarkers of the M. tuberculosis complex, using HPLC.

For performing these experiments they used samples taken during 1990 (lung tissue, bone from the right and left femurs and hand) and some additional samples were taken. Special precautions were taken during DNA extraction and PCR procedures.

DNA from the M. tuberculosis complex was detected in lung samples, gall bladder and membranous tissue by PCR, but the results were inconsistent. The authors could not perform additional characterization of M. tb DNA, as this DNA was extremely fragile. However, they performed DNA sequencing from nested PCR products. These sequences were homologous with those of M. tb. The HPLC analysis showed a good correlation between the profiles from samples collected from different sites and presence of specific biomarkers for Tb was clear. The authors thus proposed that assuming that the pulmonary exudate was the prime source of the infection, it appears that the lady Irtyersenu had pulmonary tuberculosis that had disseminated to other sites in the body.