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Interest of an interferon‐gamma release assay for diagnosing tuberulosis‐related ocular inflammation
Author(s) -
GINEYS R,
TRAD S,
TERRADA C,
LE THI HUONG DU,
FARDEAU C,
CASSOUX N,
LE HOANG P,
BODAGHI B
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.6423.x
Subject(s) - medicine , quantiferon , tuberculosis , tuberculin , gold standard (test) , uveitis , latent tuberculosis , mycobacterium tuberculosis , dermatology , immunology , pathology
Abstract Purpose Tuberculosis‐related ocular inflammation has many clinical presentations. Most of the time, bacteriological proof is not available and the diagnosis remains presumptive. Workup for another site of infection is seldom rewarding and tuberculin skin test (TST) results can be misleading. QuantiFERON‐TB Gold test is an interferon‐gamma release assay now currently available for tuberculosis screening. Methods We made a review of the charts of the patients who had had a QuantiFERON‐TB Gold test in the ophthalmology department in Pitié‐Salpêtrière, Paris, France between January and October 2007.We included patients with intraocular inflammation who had the QuantiFERON test done before the TST was performed. We decided to conduct a full anti‐tuberculosis therapeutic test in those patients who had a positive QuantiFERON‐TB Gold test result. Results We found 96 QuantiFERON‐TB Gold test results. The mean age at presentation was 51 years (22‐88, SD=17)and the F/M ratio was 60%. Patients exhibited all types of uveitis (anterior, intermediate, posterior, panuveitis) and some of them had scleritis. QuantiFERON‐TB Gold turned out positive in 41 cases, among whom 33 had positive TST, 9 had negative TST and 9 had undetermined TST. Twenty‐six patients received the treatment. At six months of follow‐up, 16 of them had no intraocular inflammation. Conclusion QuantiFERON‐TB Gold test is a convenient ancillary test compared to TST (no control visit, no stimulation of the patient's immune system). It appears useful to help identify patients with tuberculosis‐related ocular inflammation. Further studies are needed to determine whether we should use it instead of TST in this setting.