Diagnostic dilemma in tuberculous pleural effusion

Autor: Shaban Mohamed Ramadan, Somaia A. Eissa, Maha Fathi Mohammed, Mahmoud Mohamed Elbatanouny, Nabila Ibrahim Laz
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Egyptian Journal of Chest Disease and Tuberculosis, Vol 66, Iss 2, Pp 327-330 (2017)
ISSN: 0422-7638
Popis: Aim To evaluate the clinical use of interferon gamma release assays (QuantiFERON-TB Gold (In-Tube Method)) for the diagnosis of pleural tuberculosis and comparing it with ADA as a method for diagnosis TB effusion. Patients and methods 40 patients presenting with pleural effusions were classified according to their final diagnosis in two groups. Group I: Include 20 cases with tuberculous pleural effusions, group II: Control group: 20 cases divided into 2 subgroups: Subgroup11a: para pneumonic pleural effusions: 8 cases, Subgroup11b: malignant pleural effusions: 12 cases. Results Tuberculous pleural effusion showed statistically significantly lower mean age than non-tuberculous effusion. Tuberculous group showed statistically significantly highest mean ADA. This was followed by para pneumonic group then malignant group. ADA showed sensitivity (98%), specificity (55%), diagnostic accuracy (75%), negative predictive value (PV − ) (67.9%) and positive predictive value (PV + ) (91.7%) in diagnosing tuberculous effusion QuantiFERON-TB Gold showed sensitivity 65%, specificity 70%, PPV (68.4%), NPPV (66.7%) and diagnostic accuracy (67.5%) in diagnosing tuberculous effusion. Conclusion It was concluded that ADA measurement in the pleural fluid is an appropriate, fast diagnostic tool for the diagnosis of tuberculous pleural effusion, with higher sensitivity (98%) and diagnostic accuracy (75%). QuantiFERON-TB Gold which is technically more complicated, expensive and has lower sensitivity (65%) and diagnostic accuracy (67.5%) than ADA.
Databáze: OpenAIRE