Tumour Necrosis Factor-α in Comparison to Adenosine Deaminase in Tuberculous Pleuritis

Tahhan, Metin; Uğurman, Feza; Gözü, Ayşe; Akkalyoncu, Behiye; Samurkaşoğlu, Belgin

doi:10.1159/000072008

Cited by 26 publications

(27 citation statements)

References 12 publications

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“…Vankayalapati et al [26] reported that IL-18 and IFN gamma concentrations are higher in the pleural fluid of TB patients than in patients with other diseases. In another study, pleural fluid TNF alpha levels and pleural fluid/serum TNF alpha were higher in tuberculous effusions than in other exudates, but their diagnostic value appears to be poorer than that of ADA [27]. Our result differs from these studies [26,27] and we did not find a clear explanation.…”

Section: Discussioncontrasting

confidence: 93%

“…In another study, pleural fluid TNF alpha levels and pleural fluid/serum TNF alpha were higher in tuberculous effusions than in other exudates, but their diagnostic value appears to be poorer than that of ADA [27]. Our result differs from these studies [26,27] and we did not find a clear explanation. We speculate that there was a barrier separating the pleural fluid and the host's immune response due to pleural fibrosis present in patient 16.…”

Section: Discussioncontrasting

confidence: 93%

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Correlation between serum tumor necrosis factor alpha levels and clinical severity of tuberculosis

Júnior¹,

Santos²,

Castro³

et al. 2008

Braz J Infect Dis

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This study verified the correlation between the serum levels of TNF alpha and different clinical forms of tuberculosis. We described a group of 24 patients presenting several clinical forms of tuberculosis and a control group of 13 healthy individuals. The levels of TNF alpha were measured by bioassay method. The levels of TNF-alpha had significant differences between the tuberculosis and control groups. The patients with abnormal chest X-Ray findings had higher TNF alpha levels (15328.48 ± 4602.19 pg/mL) when compared to patients with normal X-Rays (3353.18 ± 1495.29 pg/mL) (p<0.05). Patients that lost weight had higher TNF alpha levels (15468.54 ± 4580.54 pg/ mL) than those that didn't loose weight (2904.98 ± 1367.89) (p<0.05). The levels of TNF alpha were higher in patients with a positive PPD skin test than in those with a negative PPD test (p<0.05). There was a positive correlation between patients' clinical severity and the serum levels of TNF alpha. In patients with successive measurements of TNF alpha, we observed that there was a drop in cytokine levels, and also a clinical improvement concomitantly. We concluded that there was a correlation between serum TNF alpha levels and chest X-Ray alterations, loss of weight, positive PPD skin test and clinical severity in patients with tuberculosis. There was evidence of a worse clinical outcome in patients with tuberculosis that presented higher TNF alpha serum levels.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussioncontrasting

confidence: 93%

Correlation between serum tumor necrosis factor alpha levels and clinical severity of tuberculosis

Júnior¹,

Santos²,

Castro³

et al. 2008

Braz J Infect Dis

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“…In the past, several biological markers have been studied to aid the diagnosis of plTB, including the measurement of pleural fluid concentrations of adenosine deaminase [50,51], tumour necrosis factor-a [52][53][54] and whole IFN-c [50,55,56], with reported diagnostic sensitivities ranging from 72-88% and specificities from 88-100% [50][51][52][53][54][55][56]. Thus, reported sensitivities of adenosine deaminase and IFN-c measurements in PE for the diagnosis of plTB are similar to the sensitivity of the T-SPOT.TB test reported in the present study, although T-SPOT.TB specificity seems lower.…”

Section: Discussionmentioning

confidence: 99%

Use of a T-cell interferon- release assay for the diagnosis of tuberculous pleurisy

Losi¹,

Bossink²,

Codecasa³

et al. 2007

European Respiratory Journal

146

142

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The diagnosis of pleural tuberculosis (plTB) by the analysis of pleural effusions (PEs) with standard diagnostic tools is difficult. In routine clinical practice, the present authors evaluated the performance of a commercially available Mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot assay on peripheral blood mononuclear cells (PBMCs) and pleural effusion mononuclear cells (PEMCs) in patients with suspect plTB.The T-SPOT.TB test (Oxford Immunotec Ltd, Abingdon, UK) was performed on PBMCs and PEMCs in 20 patients with a clinical and radiological suspect of plTB and in 21 control subjects with a diagnosis of PE of nontuberculous origin at four centres participating in the European Tuberculosis Network.In total, 18 (90%) out of 20 patients with plTB tested T-SPOT.TB-positive on PBMCs and 19 (95%) out of 20 on PEMCs. Among controls, T-SPOT.TB was positive in seven out of 21 (33%) patients when performed on PBMCs (these patients were assumed to be latently infected with MTB) and five (23%) out of 21 when performed on PEMCs. Sensitivity and specificity of T-SPOT.TB for the diagnosis of active plTB when performed on PEMCs were 95 and 76%, respectively.Enumerating Mycobacterium tuberculosis-specific T-cells in pleural effusion mononuclear cells by ELISPOT is feasible in routine clinical practice and may be useful for a rapid and accurate diagnosis of pleural tuberculosis.

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“…En relación a la prueba de ADA como diagnóstica de tuberculosis pleural, diversos autores han encontrado diferentes puntos de corte, que varían desde 30 hasta 100 UI/L (tabla 2) (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) , dependiendo esto del grupo de pacientes que formaron parte del estudio, la población cuya epidemiología del Mycobacterium es distinta y los criterios tomados en cuenta para el diagnóstico definitivo de las diferentes enfermedades que ocasionaron el derraTabla 2. Estudios realizados a lo largo del tiempo sobre el valor de la prueba de ADA y sus principales parámetros.…”

Section: Discussionunclassified

Validez de la prueba de adenosina deaminasa y del recuento diferencial de leucocitos para el diagnóstico de tuberculosis pleural

et al. 2011

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ResumenObjetivo: Determinar la validez de la prueba de adenosina deaminasa (ADA) y el recuento diferencial de leucocitos para el diagnóstico de tuberculosis pleural. Diseño: Estudio retrospectivo de precisión diagnóstica. Institución: Hospital Regional de Huacho, Ministerio de Salud, Huacho, Perú. Material: Historias clínicas de pacientes con prueba de ADA en líquido pleural. Intervenciones: Estudio de historias clínicas de pacientes a quienes se les realizó la prueba de ADA en líquido pleural, desde enero 2005 hasta diciembre 2007. El valor de la prueba de ADA y el recuento diferencial de leucocitos fueron analizados mediante la curva ROC. La sensibilidad (Se), especificidad (Sp), valores predictivos (VPP y VPN) y los cocientes de verosimilitud (CVP y CVN) fueron hallados para cada variable. Principales medidas de resultados: Punto de corte para la prueba de ADA para el diagnóstico de tuberculosis pleural. Resultados: La tuberculosis fue culpable de la mayoría de los derrames pleurales; 47,5 fue el punto de corte hallado para la prueba de ADA, con Se y Sp de 73% y 90%, respectivamente (IC 95%: 0,95; p<0,001). La curva ROC para el recuento diferencial de leucocitos dio un punto de corte de 0,725; con Se y Sp de 60,9 y 64,7, respectivamente (IC 95%: 0,47 -0,79; p=0,129). Conclusiones: El mejor punto de corte discriminatorio para el diagnóstico de tuberculosis pleural fue 47,5 UI/L. Esta prueba sirve más para confirmar el diagnóstico que para descartar la enfermedad. Además, un mayor porcentaje de linfocitos en el recuento diferencial de leucocitos (>72%) incrementaría la sospecha de tuberculosis pleural. Palabras clave: Tuberculosis pleural; adenosindesaminasa; recuento de leucocitos diferencial. AbstractObjective: To determine the validity of both adenosine diaminase (ADA) test and differential cell count for pleural tuberculosis diagnosis. Design: Retrospective study for diagnosis precision. Setting: Huacho Hospital, Ministerio de Salud, Huacho, Peru. Material: Medical records of patients with ADA test in pleural fluid. Interventions: Medical records study of patients with ADA test in pleural effusion performed from January 2005 through December 2007. ADA test values and differential cell counts were analyzed by ROC curve. Sensitivity (Se), specificity (Sp), predictive values (VPP and VPN) and likehood ratios (LRP and LRN) were found for each variable. Main outcome measures: ADA test cut-off point for pleural tuberculosis diagnosis. Results: Tuberculosis was responsible for most cases of pleural effusion; 47,5 UI/L was the cut-off point by ROC curve, with Se and Sp 73% and 90%, respectively (IC 95%: 0,74 -0,95; p<0,001). The ROC curve for differential cell count cut-off point was 0,725, with Se and Sp 60,9 and 64,7, respectively (IC 95%: 0,47 -0,79; p=0,129). Conclusions: The best cut-off point for pleural tuberculosis diagnosis was 47,5 UI/L. This test worked better to confirm the disease rather than ruling it out. Thus, a larger percentage of lymphocytes in the differential cell count (>72%) will increase the...

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Tumour Necrosis Factor-α in Comparison to Adenosine Deaminase in Tuberculous Pleuritis

Cited by 26 publications

References 12 publications

Correlation between serum tumor necrosis factor alpha levels and clinical severity of tuberculosis

Correlation between serum tumor necrosis factor alpha levels and clinical severity of tuberculosis

Use of a T-cell interferon- release assay for the diagnosis of tuberculous pleurisy

Validez de la prueba de adenosina deaminasa y del recuento diferencial de leucocitos para el diagnóstico de tuberculosis pleural

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