소아 결핵 감염 진단에 있어서 결핵 특이항원 자극 Interferon-γ 분비능 측정의 진단적 유용성

• Published in: Tuberculosis and respiratory diseases Vol. 68; no. 5; pp. 280 - 285
• Main Authors: 순유진, Eu Gene Soon, 임백근, Baek Keun Lim, 김황민, Hwang Min Kim, 남궁미경, Mee Kyung Namgoong, 차병호, Byung Ho Cha, 어영, Young Uh, 전진경, Jin Kyong Chun
• Format: Journal Article
• Language: Korean
• Published: 대한결핵 및 호흡기학회 30.05.2010; 대한결핵및호흡기학회
• Subjects: Child; Interferon-gamma Release Assay; Tuberculosis; 내과학
• ISSN: 1738-3536; 2005-6184

Background: QuantiFERON(R)-TB Gold In Tube (QFT-G IT) has been used for diagnosing Latent tuberculosis infection and active tuberculosis (TB) since 2007. However, there has not been enough data on QFT-G IT for universal use in children. In this study, we evaluated the clinical usefulness of the QFT-G IT in pediatric practice. Methods: We retrospectively reviewed the clinical records of 70 patients younger than 18 years of age who had taken QFT-G IT and had a tuberculin skin test (TST) between July 2007 and July 2009 at Wonju Christian Hospital. The subjects were divided into two groups, asymptomatic TB exposure group and disease group. Four patients who were taking immunosuppressants during the study period were excluded. Results: A total of 66 immunocompetent children were included in this study. Among 27 asymptomatic children who had contact histories of TB, 6 (22.2%) were found to be positive by QFT-G IT. Eleven (40.7%) and 5 (18.5%) children were found to be positive by TST with cutoff values of ≥5 mm and ≥10 mm, respectively. Agreement was fair to good between QFT-G IT and TST (κ=0.59: cutoff value ≥5 mm, κ=0.7: cutoff value ≥10 mm). In disease group, 14 patients (35.9%) were diagnosed with active tuberculosis, 8/14 (57.1%) were positive on TST and 9/14 (64.3%) on QFT-G IT. The positive rate of acid-fast bacilli smear, TB-polymerase chain reaction, and culture for tuberculosis was 11% (1/9), 27.3% (3/11) and 33.3% (3/9), respectively. Conclusion: Our data support that the QFT-G IT can be used as an additional diagnostic tool for Latent and active tuberculosis infection in children.