Interferon-gamma release assay has poor diagnostic accuracy in differentiating intestinal tuberculosis from Crohn's disease in tuberculosis endemic areas

Karan Sachdeva; Peeyush Kumar; Bhaskar Kante; Sudheer K. Vuyyuru; Srikant Mohta; Mukesh K. Ranjan; Mukesh K. Singh; Mahak Verma; Govind Makharia; Saurabh Kedia; Vineet Ahuja

doi:10.5217/ir.2022.00010

추천

검색

자료유형: 학술저널

저자정보: Karan Sachdeva (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences) Peeyush Kumar (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences) Bhaskar Kante (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Sudheer K. Vuyyuru (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Srikant Mohta (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Mukesh K. Ranjan (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Mukesh K. Singh (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Mahak Verma (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Govind Makharia (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Saurabh Kedia (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India) Vineet Ahuja (Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences India)

저널정보: 대한장연구학회 Intestinal research Intestinal research Vol.21 No.2

발행연도: 2023.4

수록면: 226 - 234 (9page)

DOI: 10.5217/ir.2022.00010

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Background/Aims: Intestinal tuberculosis (ITB) and Crohn’s disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the same. Methods: Patients with definitive diagnosis of ITB (n=59) or CD (n=49) who underwent IGRA testing (n=307) were retrospectively included at All India Institute of Medical Sciences, New Delhi (July 2014 to September 2021). CD or ITB was diagnosed as per standard criteria. IGRA was considered positive at >0.35 IU/mL. Relevant data was collected and IGRA results were compared between ITB and CD to determine its accuracy. Results: Among 59 ITB patients (mean age, 32.6±13.1 years; median disease duration, 1 year; male, 59.3%), 24 were positive and 35 tested negative for IGRA. Among 49 CD patients (mean age, 37.8±14.0; median disease duration, 4 years; male, 61.2%), 12 were positive and 37 tested negative for IGRA. Hence, for diagnosing ITB, IGRA showed a sensitivity, specificity, positive and negative predictive values of 40.68%, 75.51%, 66.67%, and 51.39%, respectively. The area under the curve of IGRA for ITB diagnosis was 0.66 (95% confidence interval, 0.55–0.75). In a subset (n=64), tuberculin skin test (TST) showed sensitivity, specificity, positive and negative predictive values of 64.7%, 73.3%, 73.3%, and 64.71%, respectively. IGRA and TST were concordant in 38 (59.4%) patients with κ=0.17. Conclusions: In a tuberculosis endemic region, IGRA had poor diagnostic accuracy for differentiating ITB from CD, suggesting a limited value of IGRA in this setting.

#Intestinal tuberculosis #Crohn disease #Interferon-gamma release tests #Tuberculin skin test

참고문헌 (0)

참고문헌 신청

참고문헌이 DBpia에서 서비스 중이라면, [참고문헌 신청]을 통해 등록해보세요

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!

이 논문의 저자 정보

Karan Sachdeva

소속기관 Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences

주요연구분야 의약학 > 임상의학 > 내과학

논문수 1 이용수 0

Peeyush Kumar

소속기관 Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences

주요연구분야 의약학 > 임상의학 > 내과학

논문수 2 이용수 0

Bhaskar Kante