Key result
QuantiFERON-TB Gold yields only 65% sensitivity, underperforming ADA for diagnosing tuberculous pleural effusion.
Why the study?
The clinical utility of interferon gamma release assays (QuantiFERON-TB Gold) for diagnosing tuberculous pleural effusion compared to ADA measurement was evaluated.
Does QuantiFERON-TB Gold improve diagnostic accuracy compared to ADA in patients with pleural effusions suspected of tuberculosis?
Observational (n=40)
Does QuantiFERON-TB Gold improve diagnostic accuracy compared to ADA in patients with pleural effusions suspected of tuberculosis?
ADA measurement in pleural fluid is a more sensitive and accurate diagnostic tool for tuberculous pleural effusion compared to the more expensive and complicated QuantiFERON-TB Gold assay.
Answers are grounded in this paper and cite their sources.
ADA preferred over QuantiFERON-TB Gold for tuberculous pleural effusion diagnosis; leaves open added value of interferon-gamma assays in prospective validation.
Aim To evaluate the clinical use of interferon gamma release assays (QuantiFERON-TB Gold (In-Tube Method)) for the diagnosis of pleural tuberculosis and comparing it with ADA as a method for diagnosis TB effusion. Patients and methods 40 patients presenting with pleural effusions were classified according to their final diagnosis in two groups. Group I: Include 20 cases with tuberculous pleural effusions, group II: Control group: 20 cases divided into 2 subgroups: Subgroup11a: para pneumonic pleural effusions: 8 cases, Subgroup11b: malignant pleural effusions: 12 cases. Results Tuberculous pleural effusion showed statistically significantly lower mean age than non-tuberculous effusion. Tuberculous group showed statistically significantly highest mean ADA. This was followed by para pneumonic group then malignant group. ADA showed sensitivity (98%), specificity (55%), diagnostic accuracy (75%), negative predictive value (PV − ) (67.9%) and positive predictive value (PV + ) (91.7%) in diagnosing tuberculous effusion QuantiFERON-TB Gold showed sensitivity 65%, specificity 70%, PPV (68.4%), NPPV (66.7%) and diagnostic accuracy (67.5%) in diagnosing tuberculous effusion. Conclusion It was concluded that ADA measurement in the pleural fluid is an appropriate, fast diagnostic tool for the diagnosis of tuberculous pleural effusion, with higher sensitivity (98%) and diagnostic accuracy (75%). QuantiFERON-TB Gold which is technically more complicated, expensive and has lower sensitivity (65%) and diagnostic accuracy (67.5%) than ADA.
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Ramadan et al. (2017) conducted an observational in Pleural effusion (n=40). QuantiFERON-TB Gold vs. ADA was evaluated on Sensitivity for diagnosing tuberculous pleural effusion. QuantiFERON-TB Gold showed lower sensitivity (65% vs 98%) and diagnostic accuracy (67.5% vs 75%) compared to ADA for diagnosing tuberculous pleural effusion.
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