Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Sensitivity of Whole-Blood Interferon-Gamma Release Assay According to the Severity and the Location of Disease in Patients with Active Tuberculosis

활동성 결핵의 중증도 및 병변 부위에 따른 전혈 인터페론 감마 분비능 측정의 민감도

  • Kim, Yi-Young (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Jae-Hee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Yoon-Jee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, So-Yeon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Yong-Hun (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Keum-Ju (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • HwangBo, Yup (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cha, Seung-Ick (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Jae-Yong (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Jung, Tae-Hoon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Jun-Sik (Department of Otorhinolaryngology, Kyungpook National University School of Medicine) ;
  • Kim, Chang-Ho (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • 김이영 (경북대학교 의과대학 내과학교실) ;
  • 이재희 (경북대학교 의과대학 내과학교실) ;
  • 이윤지 (경북대학교 의과대학 내과학교실) ;
  • 이소연 (경북대학교 의과대학 내과학교실) ;
  • 이용훈 (경북대학교 의과대학 내과학교실) ;
  • 최금주 (경북대학교 의과대학 내과학교실) ;
  • 황보엽 (경북대학교 의과대학 내과학교실) ;
  • 차승익 (경북대학교 의과대학 내과학교실) ;
  • 박재용 (경북대학교 의과대학 내과학교실) ;
  • 정태훈 (경북대학교 의과대학 내과학교실) ;
  • 박준식 (경북대학교 의과대학 이비인후과학교실) ;
  • 김창호 (경북대학교 의과대학 내과학교실)
  • Received : 2010.11.12
  • Accepted : 2010.12.17
  • Published : 2011.02.28
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Abstract

Background: The clinical manifestation of $M.$ $tuberculosis$ infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-${\gamma}$ release assay according to the wide spectrum of clinical phenotypes. Methods: In patients diagnosed with active TB that underwent $QuantiFERON^{(R)}$ (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. Results: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). Conclusion: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.

Keywords

References

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