Τίτλος:
Pleural fluid tests to diagnose tuberculous pleuritis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose of review
This article summarizes current data regarding the accuracy of pleural
fluid tests assisting the diagnosis of tuberculous pleuritis (TBP).
Recent findings
No pleural fluid test reliably rules-in TBP in settings with low TBP
prevalence. Interferon-g) alone or in combination with adenosine
deaminase (ADA) is more reliable than ADA for this purpose in nonlow
prevalences. ADA can reliably rule-out TBP in prevalences of less than
40% although in higher prevalences the product of interleukin-27 and
ADA is the most accurate rule-out test.
Summary
The definite diagnosis of TBP requires the isolation of Mycobacterium
tuberculosis from pleural fluid or biopsies. Because of the low
sensitivity of pleural fluid cultures and the invasiveness of pleural
biopsy techniques, the concept of a pleural fluid test that accurately
establishes or excludes TBP diagnosis has been proposed. Numerous
pleural fluid tests have been evaluated for this purpose with ADA being
the most widely accepted one. During the last years, it has been
demonstrated that the ability of ADA to rule-in or rule-out TBP is
affected by the prevalence of TBP in the setting where the test is used.
The complementary use of interferon-g or interleukin-27 increases the
ability of ADA to rule-in or rule-out the disease, respectively.
Συγγραφείς:
Skouras, Vasileios S.
Kalomenidis, Ioannis
Περιοδικό:
Current Opinion in Pulmonary Medicine
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
adenosine deaminase; interferon-gamma; interleukin-27; tuberculous
pleural effusion
DOI:
10.1097/MCP.0000000000000277
