A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis

Steingart, Karen R; Henry, Marie‐Claire; Laal, Suman; Hopewell, Philip C.; Ramsay, Andrew; Menzies, Dick; Cunningham, Jane; Weldingh, Karin; Pai, Madhukar

doi:10.1136/thx.2006.075754

Cited by 105 publications

(90 citation statements)

References 55 publications

(53 reference statements)

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“…Thus, a negative NAAT result does not exclude TB disease with certainty. Interferon gamma release assays and serology are of limited diagnostic value given that adults from TB endemic areas are expected to have high rates of positivity for these tests [48].…”

Section: Tissue Diagnosismentioning

confidence: 99%

Breast Tuberculosis

2015

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Section: Tissue Diagnosismentioning

confidence: 99%

Breast Tuberculosis

2015

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“…(17)(18)(19)(20) In a meta-analysis of extrapulmonary TB, conducted in 2007, the sensitivity of immunoenzymatic assays of PF samples ranged from 26% to 59%, despite the fact that the specificity ranged from 81% to 100%. (21) The authors concluded that although the tests were rapid, simple, and noninvasive, there was no evidence to support their use in the diagnosis of extrapulmonary TB. (21) However, none of the tests evaluated in that meta-analysis involved the determination of specific IgA to HspX recombinant antigen in PF.…”

Section: Discussionmentioning

confidence: 99%

“…(21) The authors concluded that although the tests were rapid, simple, and noninvasive, there was no evidence to support their use in the diagnosis of extrapulmonary TB. (21) However, none of the tests evaluated in that meta-analysis involved the determination of specific IgA to HspX recombinant antigen in PF. Another metaanalysis, conducted in 2009, evaluated the performance of serological tests for pulmonary TB.…”

Section: Discussionmentioning

confidence: 99%

Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural

et al. 2011

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Objective: To evaluate the accuracy of determining specific IgA to HspX recombinant antigen in pleural fluid and serum samples for the diagnosis of pleural tuberculosis in patients with pleural effusion. Methods: This was a cross-sectional study. Serum and pleural fluid samples of patients with pleural effusion and suspected of having pleural tuberculosis were tested with indirect ELISA in order to determine the optical density of specific IgA to HspX. Results: We evaluated serum and pleural fluid samples from 132 patients: 97 diagnosed with pleural tuberculosis (study group) and 35 diagnosed with pleural effusion due to other causes (control group). The determination of IgA in pleural fluid satisfactorily discriminated between pleural tuberculosis patients and control patients. The sensitivity of the test in pleural fluid and in serum was 69% and 30%, respectively, whereas the specificity was 83% and 84%, respectively. Conclusions: Our data suggest that this test can be used in the diagnosis of pleural tuberculosis. Further studies, involving larger patient samples and different epidemiological scenarios, are warranted.Keywords: Pleural effusion; Tuberculosis/diagnosis; Enzyme-linked immunosorbent assay. ResumoObjetivo: Avaliar a acurácia da dosagem de IgA contra o antígeno recombinante HspX no líquido pleural e no soro de pacientes com derrame pleural para o diagnóstico de tuberculose pleural. Métodos: Estudo transversal de teste diagnóstico. Amostras de líquido pleural e de soro de pacientes com derrame pleural e suspeita de tuberculose pleural foram avaliadas para a determinação da densidade óptica de IgA contra HspX utilizando ELISA indireto. Resultados: Foram avaliadas amostras de líquido pleural e de soro de 132 pacientes: 97 com tuberculose pleural (grupo de estudo) e 35 com derrame pleural por outras causas (grupo controle). A dosagem de IgA em líquido pleural foi capaz de discriminar os pacientes com tuberculose pleural dos controles. A sensibilidade do teste em líquido pleural e em soro foi, respectivamente, de 69% e 30%, enquanto a especificidade foi de 83% e 84%, respectivamente. Conclusões: Os dados sugerem o potencial da utilização deste teste no diagnóstico de tuberculose pleural. Estudos com amostras maiores e em diferentes cenários epidemiológicos são necessários.Descritores: Derrame pleural; Tuberculose/diagnóstico; ELISA. We sequentially included individuals who met the following inclusion criteria: being ≥ 12 years of age; presenting with free pleural fluid or pleural effusion, as demonstrated on lateral decubitus chest X-rays; and presenting with a Karnofsky performance status ≥ 60%. We excluded patients presenting with clinical or biochemical evidence of kidney, heart, or liver failure, those with a history of anticoagulant use or acetylsalicylic acid use in the 10 days preceding the procedure, those in whom the diagnosis was not confirmed, and those who did not complete all of the study procedures.All of the patients were submitted to the following: standardized interview; physica...

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“…The quest for specific and sensitive serological tests has so far failed (Steingart et al, 2011;Steingart et al, 2007). An innovative approach with high throughput screening for antibodies against the entire M. tuberculosis proteome has recently identified a small pool of antigens that are recognized in sera of patients with active tuberculosis (Kunnath-Velayudhan et al, 2010).…”

Section: Biomarkersmentioning

confidence: 99%