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Jung HJ, Kim YH, Kim YS, Jeong SY, Park SW, Seo JY, Jung H, Im JP, Kim JW, Hong SN, Lee KL. Differences in Clinical Manifestations according to the Positivity of Interferon-γ Assay in Patients with Intestinal Tuberculosis. Gut Liver 2017; 10:649-52. [PMID: 27282272 PMCID: PMC4933428 DOI: 10.5009/gnl15439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/12/2015] [Accepted: 12/26/2015] [Indexed: 01/27/2023] Open
Abstract
Intestinal tuberculosis (ITB) remains prevalent in Asia. An interferon-γ assay (QuantiFERON-TB gold test [QFT]) is considered to be an effective supplementary tool for diagnosing ITB. We retrospectively analyzed the clinical features of ITB patients based on the initial results of QFT. A total of 109 patients with ITB were enrolled, and 82 patients (75.2%) showed positive QFT results. In the QFT-positive group, the mean age (44.1±12.0 years) was significantly higher than that in the QFT-negative group (37.0±14.8, p=0.0096). Abdominal pain (p=0.006) and diarrhea (p=0.030) were more frequent in the QFT-negative group. Further, C-reactive protein (CRP) levels were significantly higher in the QFT-negative group (6.4±9.9 mg/dL) than in the QFT-positive group (1.3±2.3, p<0.001). Multivariate analysis confirmed that younger age (p=0.016), diarrhea (p=0.042), and high levels of CRP (p=0.029) were independent predictors of QFT-negative results in patients with ITB. These results suggest that prior exposure to TB, reflected by QFT positivity, may cause mild inflammation in patients with ITB.
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Affiliation(s)
- Hye Jin Jung
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.,Department of Health Promotion Center, International St. Mary's Hospital, Incheon, Korea
| | - Young-Ho Kim
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - You Sun Kim
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Seong Yeon Jeong
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Sung Won Park
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Ji Yeon Seo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyemi Jung
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Noh Hong
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kuk Lae Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Clegg TA, Good M, Doyle M, Duignan A, More SJ, Gormley E. The performance of the interferon gamma assay when used as a diagnostic or quality assurance test in Mycobacterium bovis infected herds. Prev Vet Med 2017; 140:116-121. [PMID: 28460744 DOI: 10.1016/j.prevetmed.2017.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/28/2017] [Accepted: 03/21/2017] [Indexed: 11/29/2022]
Abstract
There are two different contexts in the Irish bTB eradication programme in which the interferon-gamma assay (IFN-γ) is applied. Firstly, the IFN-γ assay is applied routinely to high risk cohorts in herds with four or more reactors to the SICTT. The IFN-γ test is then carried out on blood samples submitted to the laboratory within 8h of collection (diagnostic testing). Secondly, the use of the IFN-γ assay has recently been extended to test SICTT reactors as part of a general quality assurance (QA) scheme to monitor the performance of the SICTT. Blood samples from reactors are tested one day after blood collection (QA testing). In this study, we analysed the relative performance of the SICTT and IFN-γ when used in parallel as an 8h diagnostic test and as a 24h QA test on SICTT reactors. A total of 17,725 IFN-γ tests were included in the analysis (11,658 diagnostic tests and 6067 QA tests). Of the samples submitted for diagnostic testing, the proportion positive to IFN-γ decreased with the severity of interpretation of the SICTT result. Of the standard reactors that were tested with IFN-γ in the QA programme, 92.2% were positive to the IFN-γ test. Among animals that were SICTT -ve/IFN-γ +ve, 18.9% were positive at post-mortem compared to 11.8% of those that were SICTT +ve (standard reactor)/IFN-γ -ve. These results highlight the risk associated with retaining SICTT -ve/IFN-γ +ve animals, and suggest that prompt removal of these animals is necessary to reduce the potential for future transmission.
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Affiliation(s)
- T A Clegg
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - M Good
- Department of Agriculture, Food & the Marine, Agriculture House, Kildare St., Dublin 2, Ireland.
| | - M Doyle
- Tuberculosis Diagnostics and Immunology Research Laboratory, UCD School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
| | - A Duignan
- Department of Agriculture, Food & the Marine, Agriculture House, Kildare St., Dublin 2, Ireland.
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - E Gormley
- Tuberculosis Diagnostics and Immunology Research Laboratory, UCD School of Veterinary Medicine, University College Dublin, UCD, Belfield, Dublin 4, Ireland.
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