Tuberc Respir Dis > Volume 67(4); 2009 > Article
Tuberculosis and Respiratory Diseases 2009;67(4):331-337.
DOI: https://doi.org/10.4046/trd.2009.67.4.331    Published online October 1, 2009.
The Usefulness of Whole-blood Interferon-gamma Release Assay for the Diagnosis of Extra-pulmonary Tuberculosis.
Hye Min Lee, Sung Gun Cho, Hyung Koo Kang, Sung Woon Park, Byung Ook Lee, Jae Hee Lee, Eun Ju Jeon, Jae Chol Choi
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. medics27@cau.ac.kr
Abstract
BACKGROUND
The whole-blood interferon-gamma release assay (QuantiFERON-TB Gold [QFT-G]: Cellestis, Carnegie, Victoria, Australia) has been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. In the present study, the usefulness of QFT-G was evaluated for the diagnosis of extra-pulmonary tuberculosis (EP-TB). METHODS: From June 2006 to February 2009, we evaluated the usefulness of QFT-G in patients (n=65) suspected with EP-TB, retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the QFT-G assay were analyzed. RESULTS: EP-TB was diagnosed in 33 (51%) participants. The overall sensitivity, specificity, PPV, and NPV of the QFT-G assay for EP-TB were 78%, 79%, 81%, and 77%, respectively. Of the 33 with EP-TB, 14 (42%) were diagnosed with TB pleurisy, 7 (21%) with TB lymphadenitis, 7 (21%) with intestinal TB, and 5 (15%) with EP-TB in other sites. In subgroup analyses according by site of infection, the QFT-G showed 86% sensitivity, 64% specificity, and 78% NPV in TB pleurisy. On the other hand, the sensitivity, specificity, and NPV of the assay were 71%, 83% and 71%, respectively in TB lymphadenitis, and 86%, 100% and 88%, respectively in intestinal TB. Among the patients with suspected alternative site EP-TB, the sensitivity, specificity, and NPV of the assay were 50%, 80% and 67%, respectively. CONCLUSION: The QFT-G assay showed moderate diagnostic accuracy in EP-TB. However, negative QFT-G assay does not exclude EP-TB because of the low NPV of this assay.
Key Words: Mycobacterium tuberculosis, Interferon-gamma, Diagnosis


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