The diagnostic accuracy of pericardial and urinary lipoarabinomannan (LAM) assays in patients with suspected tuberculous pericarditis

Autor: Bongani M. Mayosi, Shaheen Pandie, Ureshnie Govender, Grant Theron, Jonathan Peter, Keertan Dheda, R Meldau, Mpiko Ntsekhe, Zita S. Kerbelker
Rok vydání: 2016
Předmět:
Adult
Lipopolysaccharides
Male
0301 basic medicine
medicine.medical_specialty
Pathology
Urinary system
Enzyme-Linked Immunosorbent Assay
HIV Infections
Sensitivity and Specificity
Likelihood ratios in diagnostic testing
Gastroenterology
Article
Mycobacterium tuberculosis
03 medical and health sciences
Pericarditis
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine
Humans
030212 general & internal medicine
Likelihood Functions
Multidisciplinary
Lipoarabinomannan
biology
business.industry
Tuberculous pericarditis
Reproducibility of Results
Pericardial fluid
Pericarditis
Tuberculous
Middle Aged
medicine.disease
biology.organism_classification
CD4 Lymphocyte Count
3. Good health
030104 developmental biology
Predictive value of tests
Multivariate Analysis
Female
business
Pericardium
Zdroj: Scientific Reports
ISSN: 2045-2322
Popis: We evaluated the diagnostic accuracy of urinary and pericardial fluid (PF) lipoarabinomannan (LAM) assays in tuberculous pericarditis (TBP). From October 2009 through September 2012, 151 patients with TBP were enrolled. Mycobacterium tuberculosis culture and/or pericardial histology were the reference standard for definite TBP. 49% (74/151), 33.1% (50/151) and 17.9% (27/151) of patients had definite-, probable-, and non-TB respectively; 69.5% (105/151) were HIV positive. LAM ELISA had the following sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive values (95% confidence interval): urinary - 17.4% (9.1–30.7), 93.8% (71.7–98.9), 2.8 (0.1–63.3), 0.9 (0.8–0.9), 88.9% (56.5–98.0), and 28.3% (17.9–41.6); PF - 11.6% (6.0–21.3), 88% (70.0–95.8), 0.9 (0.08–12.0), 1.0 (0.9–1.1), 72.7% (43.4–90.1), and 26.6% (18.2–36.9). Sensitivity increased with a CD4 ≤ 100 cells/mm3 from 3.5% to 50% (p 3.
Databáze: OpenAIRE
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