Whole-Blood Interferon-Gamma Release Assay for Diagnosis of Tuberculous Lymphadenitis

Kim, Young Keun; Uh, Young; Lee, Nam Seok; Cho, Mee Yon; Eom, Minseob; Kim, Hyo Youl

doi:10.1620/tjem.224.189

Cited by 15 publications

(16 citation statements)

References 18 publications

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“…1) (Cho et al, 2011; Jia et al, 2016; Jia et al, 2014; Kim, Ko & Kim, 2013; Kim, Kim & Woo, 2016; Kim et al, 2011; Liao et al, 2009; Lu et al, 2016; Shin et al, 2015; Song et al, 2009). The basic characteristics of each study are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Performance of interferon-γrelease assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Liu

Chen³

et al. 2017

PeerJ

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BackgroundThe diagnostic values of interferon-gamma release assays (IGRA) in tuberculosis (TB) vary a lot with different site of infections, with especially higher sensitivities in chronic forms of TB such as tuberculosis of the lymph node. We conducted a meta-analysis to comprehensively evaluate the overall accuracy of diagnostic IGRA for tuberculous lymphadenitis.MethodsPubmed, Web of Science, EMBASE, Wanfang and CNKI databases up to February 17, 2017 were searched to identify published studies. The study quality was evaluated using the QUADAS-2 checklist. The pooled estimates of diagnostic parameters were generated using a bivariate random-effects model and summary receiver operating characteristic (SROC) curves were used to summarize global performance.ResultsA total of ten qualified studies, performed in Korea or China, including 1,084 patients, were enrolled in this meta-analysis. The pooled estimates of diagnostic accuracy were as follows: sensitivity, 0.89 (95% CI [0.85–0.92]); specificity, 0.81 (95% CI [0.77–0.83]); positive likelihood ratio (PLR), 4.25 (95% CI [2.79–6.47]); negative likelihood ratio (NLR), 0.16 (95% CI [0.12–0.22]); and area under the curve (AUC) was 0.93. According to subgroup analyses, studies conducted using QuantiFERON-TB, in Korean population and focusing on cervical lymphadenitis exhibited relative higher specificity while lower sensitivity. No evidence of publication bias was identified.ConclusionsIGRA exhibits high diagnostic accuracy in tuberculous lymphadenitis. The diagnostic value of IGRA differed by different IGRA methods, ethnicity and lymphadenitis location. Our conclusion may be more applicable to population from TB prevalent areas.

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Section: Resultsmentioning

confidence: 99%

Performance of interferon-γrelease assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Liu

Chen³

et al. 2017

PeerJ

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“…However, the IGRA studies focused on the detection of active pulmonary TB, but there are limited data of diagnostic performance focused on extrapulmonary TB, such as tuberculous lymphadenitis (23)(24)(25)(26). Although there was a very small number of patients (total 68 patients with TB lymphadenitis), the IGRA showed a sensitivity of approximately 90% in TB lymphadenitis based on these studies.…”

Section: Discussionmentioning

confidence: 98%

Esophagomediastinal Fistula Secondary to Multidrug-resistant Tuberculous Mediastinal Lymphadenitis

Lee

et al. 2014

Intern. Med.

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Esophagomediastinal fistula secondary to mediastinal tuberculosis (TB) lymphadenitis is a rare and unusual complication. A 32-year-old woman visited our clinic because of chest pain. Computed tomography (CT) demonstrated an esophagomediastinal fistula with subcarinal lymphadenopathy and no remarkable parenchymal lung lesions. The esophagomediastinal fistula was confirmed by esophagoscopy; however, the patient's bronchoscopy findings were unremarkable. The endobronchial ultrasound-guided lymph node aspiration did not confirm a diagnosis of TB. Finally, the patient was diagnosed via a lymph node biopsy. A drugsensitivity test revealed the presence of a multidrug-resistant pathogen. To the best of our knowledge, this is the first case of esophagomediastinal fistula secondary to multidrug-resistant (MDR-) TB mediastinal lymphadenitis.

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“…The overall annual incidence ranged from 0.0% to 1.05% of all TB infections. Some investigators have reported that IGRAs are useful for diagnosing E-TB, which includes TB lymphadenitis most commonly, and pleural, skeletal, central nervous system, and abdominal TB less commonly [7-9,23]. The reported sensitivities and specificities of IGRAs for the diagnosis of E-TB are 69% to 94% and 82% to 88%, collectively, and vary among disease sites [7-9].…”

Section: Discussionmentioning

confidence: 99%

“…The reported sensitivities and specificities of IGRAs for the diagnosis of E-TB are 69% to 94% and 82% to 88%, collectively, and vary among disease sites [7-9]. In patients with suspected TB lymphadenitis, blood IGRA may be useful adjunct assay to diagnose or exclude E-TB [8,23], but blood IGRA alone is not useful for diagnosis of TB of the spine or central nervous system [8,24]. Previous studies included no or few, if any, hepatic or splenic TB patients and no other studies have evaluated the usefulness of the QFT-GIT for diagnosing hepatic or splenic TB in hematologic patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and the usefulness of the QuantiFERON-TB Gold In-Tube test in hematologic patients with hepatic or splenic lesions

Kwon¹,

Kim

Choi

et al. 2013

Korean J Intern Med

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Background/AimsHepatic or splenic lesions in hematologic patients are not defined well because they are not easy to evaluate due to limitations of invasive procedures. Management typically depends on the clinical diagnosis with few microbiological data.MethodsWe reviewed the medical records of consecutive hematologic patients with hepatic or splenic lesions in the infectious diseases unit from April 2009 to December 2010 at the Catholic Hematopoietic Stem Cell Transplantation Center in Korea.ResultsTwenty-six patients were identified. Their mean age was 46.0 ± 14.7 years, and 16 (61.5%) were male. Underlying diseases were acute myelogenous leukemia (n = 15, 57.7%) and myelodysplastic syndrome (n = 6, 23.1%). Among the nine nontuberculous infectious lesions, two bacterial, six fungal, and one combined infection were identified. The numbers of confirmed, probable, and possible tuberculosis (TB) cases were one, three, and four, respectively. Two patients had concurrent pulmonary TB. QuantiFERON-TB Gold In-Tube (QFT-GIT, Cellestis Ltd.) was positive in seven cases, among which six were diagnosed with TB. The sensitivity and specificity of QFT-GIT were 75% and 81.3%. Nine (34.6%) were defined as noninfectious causes.ConclusionsCauses of hepatic or splenic lesion in hematologic patients were diverse including TB, non-TB organisms, and noninfectious origins. TB should be considered for patients not responding to antibacterial or antifungal drugs, even in the absence of direct microbiological evidence. QFT-GIT may be useful for a differential diagnosis of hepatosplenic lesions in hematologic patients.

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Whole-Blood Interferon-Gamma Release Assay for Diagnosis of Tuberculous Lymphadenitis

Cited by 15 publications

References 18 publications

Performance of interferon-γrelease assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Performance of interferon-γrelease assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis

Esophagomediastinal Fistula Secondary to Multidrug-resistant Tuberculous Mediastinal Lymphadenitis

Clinical characteristics and the usefulness of the QuantiFERON-TB Gold In-Tube test in hematologic patients with hepatic or splenic lesions

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