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IGRA tuberculosis pleural effusion

Ana Braga, Afonso Oliveira, Kevin Domingues, Maria João Andrade, Miguel Abecacis, José Pedro Neves
INTRODUCTION: Chronic constrictive pericarditis (CCP) is a disease that has multiple possible causes and is associated with variable clinical findings, depending on its severity. It develops insidiously, and in many cases, particularly in developed countries, no antecedent diagnosis can be found. These cases are termed idiopathic. Tuberculosis is the leading cause of constrictive pericarditis in developing nations but represents only a small minority in developed countries. METHODS: Here the authors describe two different case reports where tuberculosis was the probable cause of CCP...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
S Ramos, R Gaio, F Ferreira, J Paulo Leal, S Martins, J Vasco Santos, I Carvalho, R Duarte
SETTING: Confirmation of tuberculosis (TB) in children is difficult, so clinicians use different procedures when deciding to treat. OBJECTIVE: Identify criteria to initiate and maintain TB treatment in children younger than 5 years-old, without diagnosis confirmation. DESIGN: A web-based survey was distributed by email to the corresponding authors of journal articles on childhood TB. The observations were clustered into disjoint groups, and analyzed by Ward's method...
November 2017: Revista Portuguesa de Pneumologia
Bastien Mollo, Stéphane Jouveshomme, François Philippart, Benoît Pilmis
Tuberculosis is one of the main etiologies to evoke in the context of lymphocyte pleurisy. However, diagnosis is difficult and is based on mycobacteriology that is not enough sensitive and time-consuming, or on histology that requires invasive biopsy gesture. This literature review, carried out from Medline, summarizes the main meta-analyzes, reviews, and originator publications in English on biomarkers, classic and more innovative, studied for the diagnosis of tuberculous pleurisy. Among the immuno-biochemical markers, interferon-γ (IFN-γ), isoenzyme of adenosine deaminase 2 (ADA2) and total adenosine deaminase (ADA) seem the most relevant with respective sensitivities of 89% (87-91), 97...
February 1, 2017: Annales de Biologie Clinique
Tika Adilistya, Dalima Aw Astrawinata, Ujainah Z Nasir
AIM: to evaluate the diagnostic value of an interferon-gamma release assay (IGRA) with enzyme-linked immunospot (ELISPOT) method, T-SPOT.TB, in the diagnosis of pleural TB using pleural fluid mononuclear cells (PFMC). METHODS: forty-eight subjects, presumed to have pleural TB with exudative pleural effusion by Light's criteria, dominated by mononuclear cells, had their pleural fluid specimen tested with T-SPOT.TB, Mycobacterial Growth Indicator Tube (MGIT) culture, and adenosine deaminase (ADA) activity...
January 2016: Acta Medica Indonesiana
Ashutosh N Aggarwal, Ritesh Agarwal, Dheeraj Gupta, Sahajal Dhooria, Digambar Behera
The role of interferon gamma release assays (IGRAs), although established for identifying latent tuberculosis, is still evolving in the diagnosis of active extrapulmonary tuberculosis. We systematically evaluated the diagnostic performance of blood- and pleural fluid-based IGRAs in tuberculous pleural effusion (TPE). We searched the PubMed and Embase databases for studies evaluating the use of commercially available IGRAs on blood and/or pleural fluid samples for diagnosing TPE. The quality of the studies included was assessed through the QUADAS-2 tool...
August 2015: Journal of Clinical Microbiology
Qianting Yang, Yi Cai, Wei Zhao, Fan Wu, Mingxia Zhang, Kai Luo, Yan Zhang, Haiying Liu, Boping Zhou, Hardy Kornfeld, Xinchun Chen
The diagnosis of active tuberculosis (TB) disease remains a challenge, especially in high-burden settings. Cytokines and chemokines are important in the pathogenesis of TB. Here we investigate the usefulness of circulating and compartmentalized cytokines/chemokines for diagnosis of TB. The levels of multiple cytokines/chemokines in plasma, pleural fluid (PF), and cerebrospinal fluid (CSF) were determined by Luminex liquid array-based multiplexed immunoassays. Three of 26 cytokines/chemokines in plasma were significantly different between TB and latent tuberculosis infection (LTBI)...
December 2014: Clinical and Vaccine Immunology: CVI
Fei Liu, Mengqiu Gao, Xia Zhang, Fengjiao Du, Hongyan Jia, Xinting Yang, Zitong Wang, Liqun Zhang, Liping Ma, Xiaoguang Wu, Li Xie, Zongde Zhang
BACKGROUND: The diagnosis of pleural tuberculosis (TB) remains to be difficult. Interferon-gamma release assay (IGRA) is a promising method for diagnosing TB in low TB burden countries. The release of interferon-gamma (IFN-γ) by T lymphocytes increases at a localized site of infection with Mycobacterium tuberculosis antigen. This study aimed to examine the clinical accuracy of T-SPOT.TB on pleural fluid and peripheral blood for the diagnosis of pleural TB in high TB burden country. METHODS: 168 subjects with pleural effusion were enrolled prospectively and examined with T-SPOT...
2013: PloS One
Li-Ta Keng, Chin-Chung Shu, Jason Yao-Ping Chen, Sheng-Kai Liang, Ching-Kai Lin, Lih-Yu Chang, Chia-Hao Chang, Jann-Yuan Wang, Chong-Jen Yu, Li-Na Lee
OBJECTIVE: Conventional methods for diagnosing tuberculous pleurisy (TB pleurisy) are either invasive or have a long turn-around-time. Performances of pleural adenosine deaminase (ADA), ADA2, interferon-gamma (IFN-γ), and interferon-gamma release assays (IGRA) as diagnostic tools for TB pleurisy were evaluated. METHODS: Eighty-eight patients with lymphocyte-predominant pleural exudates between June 2010 and March 2011, including 31 with clinically diagnosed TB pleurisy, were prospectively studied...
October 2013: Journal of Infection
Joanna Klimiuk, Rafał Krenke
Although tuberculosis is one of the most common causes of pleural effusion, diagnosis of tuberculous pleuritis still remains a challenge. This is due to paucity of M. tuberculosis organisms in pleural effusion which results in a relatively low sensitivity of the routinely used diagnostic methods. Thus, different biomarkers in pleural effusion have been extensively studied in order to improve the diagnostic accuracy. Pleural fluid deaminase adenosine activity (ADA) and interferon gamma (IFN-γ) concentration have been shown to be the most reliable and cost-effective markers of tuberculous pleurisy...
2011: Pneumonologia i Alergologia Polska
Qiong Zhou, Yi-Qiang Chen, Shou-Ming Qin, Xiao-Nan Tao, Jian-Bao Xin, Huan-Zhong Shi
BACKGROUND AND OBJECTIVE: The diagnosis of tuberculous pleurisy by analysis of pleural fluid using standard diagnostic tools is difficult. Recently, T-cell interferon-γ release assays (IGRA) have been introduced for the diagnosis of tuberculous pleurisy. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of IGRA on both pleural fluid and peripheral blood, for diagnosing tuberculous pleurisy. METHODS: A systematic review was performed of English language publications...
April 2011: Respirology: Official Journal of the Asian Pacific Society of Respirology
J Ortmann, H Schiffl, S M Lang
HISTORY AND CLINICAL FINDINGS: A 36-year-old patient suffered from repeated exsudative pleural effusions and renal insufficiency (serum creatinine 1.9 mg/dl) combined with glomerular erythrocyturia, proteinuria and renal hypertension. INVESTIGATIONS: The diagnosis of the underlying etiology of the pleural effusions was difficult in spite of a thorough diagnostic work-up. Pleural tuberculosis was finally detected by an interferon gamma release assay (IGRA). Kidney biopsy revealed mesangioproliferative glomerulonephritis, immunhistology showed mesangial IgA deposits...
June 2010: Deutsche Medizinische Wochenschrift
Rafał Krenke, Piotr Korczyński
PURPOSE OF REVIEW: This review aims to define the role of adenosine deaminase (ADA) and interferon gamma (IFN-gamma) in the differential diagnosis of pleural effusion with special attention to their source, mechanism of release and methods of measurement in pleural fluid. The diagnostic performance of ADA and IFN-gamma is analyzed, and the advantages and limitations of their use in differentiating between tuberculous and nontuberculous pleural effusion are discussed. RECENT FINDINGS: Several potential biomarkers of tuberculous pleurisy have been evaluated, but none have been found to be clearly superior to pleural fluid level of ADA or IFN-gamma...
July 2010: Current Opinion in Pulmonary Medicine
Clare E Hooper, Y C Gary Lee, Nick A Maskell
PURPOSE OF REVIEW: T-cell interferon-gamma release assay (IGRA) use in tuberculosis (TB) contact screening and latent TB diagnosis is established and supported by American and European guidelines. However, questions remain regarding their clinical utility beyond conventional tests in the investigation of suspected active TB. We review the evidence base for IGRAs in the diagnosis or exclusion of pleural TB. RECENT FINDINGS: The specificity of IGRAs for diagnosis of active TB disease is limited by an inability to distinguish latent disease...
July 2009: Current Opinion in Pulmonary Medicine
K Dheda, R N van Zyl-Smit, L A Sechi, M Badri, R Meldau, S Meldau, G Symons, P L Semple, A Maredza, R Dawson, H Wainwright, A Whitelaw, Y Vallie, P Raubenheimer, E D Bateman, A Zumla
The clinical utility of antigen-specific interferon (IFN)-gamma release assays (IGRAs) using pleural mononuclear cells, for the diagnosis of tuberculosis (TB), requires clarification. We compared the diagnostic utility of unstimulated pleural IFN-gamma levels with several pleural antigen-specific T-cell IGRAs (early secretory antigenic target-6 and culture filtrate protein-10 (T-SPOT.(R)TB, QuantiFERON(R)-TB Gold In-tube), purified protein derivative (PPD) and heparin-binding haemagglutinin (HBHA)) in 78 South African TB suspects...
November 2009: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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