Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Tapping the usefulness of Whole Blood Interferon-${\gamma}$ Assay for Diagnosing Tuberculosis Infection in Children

소아 결핵 감염 진단에 있어서 결핵 특이항원 자극 Interferon-${\gamma}$ 분비능 측정의 진단적 유용성

  • Soon, Eu-Gene (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Lim, Baek-Keun (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Hwang-Min (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • NamGoong, Mee-Kyung (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Cha, Byung-Ho (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Uh, Young (Department of Laboratory Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Chun, Jin-Kyong (Department of Pediatrics, Wonju Christian Hospital, Yonsei University Wonju College of Medicine)
  • 순유진 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실) ;
  • 임백근 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실) ;
  • 김황민 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실) ;
  • 남궁미경 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실) ;
  • 차병호 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실) ;
  • 어영 (연세대학교 원주의과대학 원주기독병원 진단검사의학교실) ;
  • 전진경 (연세대학교 원주의과대학 원주기독병원 소아청소년과학교실)
  • Received : 2010.03.24
  • Accepted : 2010.05.10
  • Published : 2010.05.30
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Abstract

Background: $QuantiFERON^{(R)}$-TB Gold In Tube (QFT-G IT) has been used for diagnosing latent tuberculosis infection and active tuberculosis (TB) since 2007. However, there has not been enough data on QFT-G IT for universal use in children. In this study, we evaluated the clinical usefulness of the QFT-G IT in pediatric practice. Methods: We retrospectively reviewed the clinical records of 70 patients younger than 18 years of age who had taken QFT-G IT and had a tuberculin skin test (TST) between July 2007 and July 2009 at Wonju Christian Hospital. The subjects were divided into two groups, asymptomatic TB exposure group and disease group. Four patients who were taking immunosuppressants during the study period were excluded. Results: A total of 66 immunocompetent children were included in this study. Among 27 asymptomatic children who had contact histories of TB, 6 (22.2%) were found to be positive by QFT-G IT. Eleven (40.7%) and 5 (18.5%) children were found to be positive by TST with cutoff values of ${\geq}5mm$ and ${\geq}10mm$, respectively. Agreement was fair to good between QFT-G IT and TST (${\kappa}=0.59$: cutoff value ${\geq}5mm$, ${\kappa}=0.7$: cutoff value ${\geq}10mm$). In disease group, 14 patients (35.9%) were diagnosed with active tuberculosis, 8/14 (57.1%) were positive on TST and 9/14 (64.3%) on QFT-G IT. The positive rate of acid-fast bacilli smear, TB-polymerase chain reaction, and culture for tuberculosis was 11% (1/9), 27.3% (3/11) and 33.3% (3/9), respectively. Conclusion: Our data support that the QFT-G IT can be used as an additional diagnostic tool for latent and active tuberculosis infection in children.

Keywords

References

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