Usefulness of the QuantiFERON-TB GOLD in Tube Test for the Differantial Diagnosis of Sarcoidosis from Tuberculosis Lymphadenitis

Yıl 2017, Cilt: 6 Sayı: 3, 93 - 99, 01.09.2017

Emine Özsarı Hülya Şimşek Ayşe Gözü Belgin Samurkaşoğlu

https://doi.org/10.5505/abantmedj.2017.42275

Öz

INTRODUCTION: There is one of the new methods in the differential diagnosis QuantiFERON-TB Gold in tube QFTGIT , in which the most common cause of sarcoidosis and tuberculosis lymphadenitis of benign mediastinal lymphadenopathy, we aimed to investigate the value of the test for TB lymphadenitis. METHODS: Chest CT transverse diameter of 10 mm and directed to our clinic to investigate the etiology of mediastinal lymph nodes above sarcoidosis was diagnosed in 36 patients with TB lymphadenitis was diagnosed in 37 patients, including 73 patients age, sex, comorbid disease, the tuberculosis contact history, symptoms, number of BCG scar, TST and QFTGIT results were recorded test results. RESULTS: The mean age of patients with sarcoidosis 42.2± 17.2 were female 52.8% , 17 were male 47.2% . Average follow-up time was 14.6 ± 12.3 months. 3-36 months . With sarcoidosis, which is still being used in the differential diagnosis of TB lymphadenitis, TCT's sensitivity in diagnosis of TB lymphadenitis was 62%, specificity 75%; QFT-GIT sensitivity of the test was 92%, specificity of 83% was calculated. Sarcoidosis QFT-GIT and TST test results of there were no significant correlation between [p = 0.618]; Significant correlation was found for TB lymphadenitis [p = 0.028]. DISCUSSION AND CONCLUSION: As our country and communities of routine BCG vaccination should be vaccinated again applied according to TST results, BCG also affected in the differential diagnosis of tuberculosis infection, QFT-GIT be recommended for use with the TST test. Also planned patients receiving systemic steroid therapy for starting INH prophylaxis be taken into account rather than the TST positive QFT-GIT test may be appropriate.

Anahtar Kelimeler

Sarcoidosis, tuberculosis lymphadenitis, tuberculin skin test, QuantiFERON-TB GOLD in Tube test, mediastinal lymphadenopathy

Evre 1 ve Evre 2 Sarkoidoz ile Tüberküloz Lenfadenit Hastalıklarının Ayırıcı Tanısında QuantiFERON–TB GOLD in Tube Testinin Rolü

Öz

GİRİŞ ve AMAÇ: Mediastinal benign lenfadenopatinin en sık nedenleri sarkoidoz ve tüberküloz lenfadenit hastalıklarıdır. Çalışmamızda, TB lenfadenitin ayırıcı tanısında yeni yöntemlerden birisi olan QuantiFERON–TB Gold in tube QFTGIT testinin değerini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Toraks BT’de transvers çapı 10 mm ve üzerinde olan mediastinal lenf nodlarının etiyolojisinin araştırılması amacıyla kliniklerimize yönlendirilerek 36’sı sarkoidoz ve 37’si TB lenfadenit tanısı konulan toplam 73 hastanın prospektif olarak yaş, cinsiyet, eşlik eden ek hastalık, tüberküloz temas öyküsü, semptomları, BCG skar sayısı, TCT sonuçları ve QFT-GIT testi sonuçları kaydedildi. BULGULAR: Sarkoidoz hastalarının yaş ortalamaları 42,2±17,2 idi. Olguların 19’u kadın %52.8 , 17’si erkekti % 47,2 . Ortalama takip süreleri 14,6±12,3 ay idi 3 – 36 ay . Sarkoidoz ile TB lenfadenit ayırıcı tanısında halen kullanılmakta olan TCT nin, TB lenfadenit tanısında duyarlılığı %62, özgüllüğü %75; QFT-GIT testinin duyarlılığı %92, özgüllüğü %83 olarak hesaplandı. Sarkoidozda QFT-GIT testi ve TCT sonuçları arasında anlamlı korelasyon bulunmazken [p=0,618]; TB lenfadenit için anlamlı korelasyon saptandı [p=0,028]. TARTIŞMA ve SONUÇ: Ülkemizde olduğu gibi rutin BCG aşılamasının ve TCT sonucuna göre yeniden aşılanmaların uygulandığı topluluklarda, tüberküloz enfeksiyonun ayırıcı tanısında BCG den etkilenmeyen QFT-GIT testinin TCT ile birlikte kullanılması önerilebilir. Ayrıca sistemik steroid tedavisi alması planlanan hastalarda INH proflaksisi başlanması için tek başına TCT’den ziyade QFT-GIT testi pozitifliğinin gözönüne alınması uygun olabilir.

Anahtar Kelimeler

Sarkoidoz, tüberküloz lenfadenit, tüberkülin cilt testi, QuantiFERON TB–Gold in tube test, mediastinal lenfadenopati

Kaynakça

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