Prospective Evaluation of the Clinical Utility of Interferon-gamma Assay in the Differential Diagnosis of Intestinal Tuberculosis and Crohn's Disease

Title
Prospective Evaluation of the Clinical Utility of Interferon-gamma Assay in the Differential Diagnosis of Intestinal Tuberculosis and Crohn's Disease
Author(s)
장병익김범진[김범진]최용성[최용성]박영숙[박영숙]김원호[김원호]김유선[김유선]정성애[정성애]한동수[한동수]김주성[김주성]최재현[최재현]최창환[최창환]진윤태[진윤태]천재희[천재희]예병덕[예병덕]양석균[양석균]김영호[김영호]
Keywords
ACTIVE PULMONARY TUBERCULOSIS; INFLAMMATORY-BOWEL-DISEASE; CELL-BASED ASSAY; EXTRAPULMONARY TUBERCULOSIS; RELEASE ASSAY; SKIN-TEST; EPIDEMIOLOGY; BURDEN; SENSITIVITY; INFECTION
Issue Date
201106
Publisher
WILEY-BLACKWELL
Citation
INFLAMMATORY BOWEL DISEASES, v.17, no.6, pp.1308 - 1313
Abstract
Background: Distinguishing intestinal tuberculosis (ITB) from Crohn's disease (CD) is challenging. This study prospectively evaluated the clinical utility of the QuantiFERON-TB gold test (QFT) in the differential diagnosis of ITB and CD, and compared it with the clinical utility of the tuberculin skin test (TST). Methods: Patients with suspected ITB or CD on colonoscopic findings were enrolled from 13 hospitals in Korea between June 2007 and November 2008. A QFT and TST were performed. When the initial diagnosis was not confirmed, 2-3 months of empiric antituberculous therapy was administered. Results: In all, 128 patients were analyzed; 64 patients had ITB and 64 patients had CD. The median age of patients with ITB was greater than the patients with CD (47 years versus 31 years, P < 0.001). The positive rate for the QFT and TST (>= 10 mm) in patients with ITB was significantly higher than patients with CD (67% versus 9% and 69% versus 16%, respectively; P < 0.001). The QFT and TST had good agreement (kappa = 0.724, P < 0.001). The diagnostic validity of QFT in ITB had a 67% sensitivity, 90% specificity, 87% positive predictive value, and 73% negative predictive value. There was no difference in these parameters between the QFT and TST. The likelihood ratio for a positive QFT was higher than a positive TST in the diagnosis of ITB (7.1 and 4.4, respectively). Conclusions: The QFT is a limited but useful diagnostic aid in combination with the TST in the diagnosis of ITB.
URI
http://hdl.handle.net/YU.REPOSITORY/25109http://dx.doi.org/10.1002/ibd.21490
ISSN
1078-0998
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의과대학 > 내과학교실 > Articles
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