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Diagnostic usefulness of a T-cell-based assay for extrapulmonary tuberculosis in immunocompromised patients
DC Field | Value | Language |
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dc.contributor.author | Kim, Sung-Han | - |
dc.contributor.author | Song, Kyoung-Ho | - |
dc.contributor.author | Choi, Su-Jin | - |
dc.contributor.author | Kim, Hong-Bin | - |
dc.contributor.author | Kim, Nam-Joong | - |
dc.contributor.author | Oh, Myoung-don | - |
dc.contributor.author | Choe, Kang-Won | - |
dc.date.accessioned | 2010-01-28 | - |
dc.date.available | 2010-01-28 | - |
dc.date.issued | 2009-02-03 | - |
dc.identifier.citation | Am J Med. 2009 Feb;122(2):189-95. | en |
dc.identifier.issn | 1555-7162 (Electronic) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19185094 | - |
dc.identifier.uri | http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TDC-4VG98GH-J-1&_cdi=5195&_user=168665&_orig=search&_coverDate=02%2F28%2F2009&_sk=998779997&view=c&wchp=dGLzVlz-zSkWz&md5=c30c37ae87947c9a197058e6f70b11f9&ie=/sdarticle.pdf | - |
dc.identifier.uri | https://hdl.handle.net/10371/45949 | - |
dc.description.abstract | BACKGROUND: The low reactivity of the tuberculin skin test limits its clinical use in immunocompromised patients with extrapulmonary tuberculosis. A recently developed T-cell-based assay for diagnosing tuberculosis infection gave promising results. However, there were few data on the usefulness of this assay for diagnosing extrapulmonary tuberculosis in immunocompromised patients. METHODS: All adult patients with suspected extrapulmonary tuberculosis were prospectively enrolled at 2 university-affiliated hospitals over an 18-month period. In addition to the conventional tests for diagnosing extrapulmonary tuberculosis, enzyme-linked immunospot (ELISPOT) assay for the interferon-gamma-producing T-cell response to early secretory antigenic target-6 and culture filtrate protein-10 was performed. The final diagnoses in patients with suspected extrapulmonary tuberculosis were classified by clinical category. RESULTS: There were 179 patients with suspected extrapulmonary tuberculosis enrolled: 59 (33%) were classified as immunocompromised. Of the 179 patients, 75 (42%) were classified as extrapulmonary tuberculosis, including 56 confirmed tuberculosis plus 19 probable tuberculosis, and 97 (54%) were classified as not tuberculosis. The remaining 7 (4%) had possible tuberculosis and were excluded from the final analysis. The tuberculin skin test (induration size >or=10 mm) was less sensitive in immunocompromised patients (38%; 95% confidence interval [CI], 19%-59%) than in immunocompetent patients (69%; 95% CI, 54%-81%, P=.01). In contrast, the ELISPOT assay retained a high sensitivity: (88%; 95% CI, 68%-97%) in immunocompromised patients compared with 96% (95% CI, 87%-100%) in immunocompetent patients (P=.32). CONCLUSION: The immunosuppressive condition does not affect the diagnostic sensitivity of the ELISPOT assay for extrapulmonary tuberculosis. | en |
dc.language.iso | en | en |
dc.publisher | Elsevier | en |
dc.subject | Adult | en |
dc.subject | Antigens, Bacterial/immunology | en |
dc.subject | Bacterial Proteins/immunology | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Interferon-gamma/metabolism | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Predictive Value of Tests | en |
dc.subject | Sensitivity and Specificity | en |
dc.subject | T-Lymphocytes/*immunology | en |
dc.subject | Tuberculin Test | en |
dc.subject | Tuberculosis/*diagnosis/immunology | en |
dc.subject | Enzyme-Linked Immunosorbent Assay | - |
dc.subject | Immunocompromised Host | - |
dc.title | Diagnostic usefulness of a T-cell-based assay for extrapulmonary tuberculosis in immunocompromised patients | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 김성한 | - |
dc.contributor.AlternativeAuthor | 송경호 | - |
dc.contributor.AlternativeAuthor | 최수진 | - |
dc.contributor.AlternativeAuthor | 김홍빈 | - |
dc.contributor.AlternativeAuthor | 김남중 | - |
dc.contributor.AlternativeAuthor | 오명돈 | - |
dc.contributor.AlternativeAuthor | 최강원 | - |
dc.identifier.doi | 10.1016/j.amjmed.2008.07.028 | - |
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