Abstract
Introduction: Among the extra pulmonary tuberculosis, the tuberculous pleurisy takes the second place after peripheral tuberculous lymphadenitis in our country.
The diagnosis is usually difficult, due to the low sensitivity of conventional methods.
The new immunological tests have been used to improve the diagnostic sensitivity of tuberculous pleurisy and overcome the inadequacies of conventional methods.
Interferon gamma (IFN-γ) is one of these tests.
Objective: Assess the performance and clinical interest of QuantiFERON-TB Gold In-Tube (QFT-GIT) in the tuberculous pleurisy diagnosis.
Methods: The QuantiFERON TB-Gold In Tube (QFT-GIT) test was analysed in blood and pleural fluid from 158 immunocompetent patients (84 patients for the tuberculous group and 74 patients for the non-tuberculous group)
Results: The QFT-GIT in pleural fluid was positive in 82 (97.6.5%) patients and indeterminate in 2 (2, 4%) patients in the tuberculous pleurisy group which was also confirmed by the conventional methods. There was not a single patient with a negative test result in this group. In blood, the QFT-GIT was positive in 68(81%), negative in 11 (13%) and indeterminate in 5 (6%).
The sensitivity, specificity, positive predictive value and negative predictive value of QFT-GIT in pleural fluid for tuberculous pleurisy were 95.1%, 67, 7%, 66, 1% and 95, 5%; and of QFT-GIT in blood the results were 86, 1%, 84, 5%, 86, 1% and 84, 5% respectively.
In conclusion: QFT-GIT in the blood and in the pleura appears to be a useful test in our study for the diagnosis of tuberculous pleurisy despite the fact that its specificity is low in the pleura.
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