Diagnostic performance of interferon‐gamma release assay for diagnosis of tuberculous pericarditis: A meta‐analysis

Abstract

Background The diagnosis of tuberculous pericarditis is difficult to set, not only for its non‐specific clinical presentation, but also for the lack of useful diagnostic tests. We comprehensively evaluate the overall diagnostic accuracy of Interferon‐gamma release assays (IGRA) upon tuberculous pericarditis by meta‐analysis. Methods We searched PubMed, Embase and Cochrane Library database from the earliest available date of indexing through April 30, 2019. The study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS2) checklist. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−) and constructed summary receiver operating characteristic curves parameters. Results Across six results from five studies (415 patients), the pooled sensitivity for IGRA methods was 0.94 (95% confidence interval [CI]; 0.87‐0.98) with heterogeneity (χ2 = 69.9, P = .01) and a pooled specificity of 0.94 (95% CI; 0.75‐0.94) without heterogeneity (χ2 = 41.1, P = .13). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 16.8 (95% CI; 8.0‐35.4) and negative likelihood ratio (LR−) of 0.06 (95% CI; 0.03‐0.13). The pooled diagnostic odds ratio was 278 (95% CI; 114‐6806). Conclusions Interferon‐gamma release assays demonstrated good sensitivity and specificity for diagnosis of tuberculous pericarditis. At present, the literature regarding remains the use of IGRA for diagnosis of tuberculous pericarditis still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of IGRA test for the diagnosis of tuberculous pericarditis.

Pericarditis due to Campylobacter coli infection: a case report

“…Interferon-gamma release assays (IGRAs) are another test that can detect tuberculous pericarditis. Another recently published meta-analysis of tuberculous pericarditis for IGRA utility discovered a pooled sensitivity of 0.94, specificity of 0.94, and negative likelihood of 6% [ 22 ]. IGRA is more sensitive and specific than ADA.…”

Tuberculous Pericarditis—Own Experiences and Recent Recommendations

“…False-positive results may occur in patients with pericarditis during the course of lymphoma, rheumatoid arthritis, or empyema. Other markers of tuberculous pericarditis with ancillary importance are interferon-gamma (>50 pg/L) and tissue lysozyme (>6.5 mcg/dL) [17,29,32,[42][43][44].…”

“…Tests based on the production of interferon-gamma via peripheral blood lymphocytes in response to stimulation from specific mycobacterial antigens (IGRAs) allow for the diagnosis of latent tuberculosis infection (LTBI), with higher specificity than TST. The role of IGRAs in the diagnosis of tuberculous pericarditis has not been specified [42].…”