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Prospective evaluation of the clinical utility of interferon-γ assay in the differential diagnosis of intestinal tuberculosis and Crohn's disease

Title
Prospective evaluation of the clinical utility of interferon-γ assay in the differential diagnosis of intestinal tuberculosis and Crohn's disease
Authors
Kim B.J.Choi Y.S.Jang B.I.Park Y.S.Kim W.H.Kim Y.S.Jung S.-A.Han D.S.Kim J.S.Choi J.H.Choi C.H.Jeen Y.T.Cheon J.H.Ye B.D.Yang S.-K.Kim Y.-H.
Ewha Authors
정성애
SCOPUS Author ID
정성애scopus
Issue Date
2011
Journal Title
Inflammatory Bowel Diseases
ISSN
1078-0998JCR Link
Citation
vol. 17, no. 6, pp. 1308 - 1313
Indexed
SCI; SCIE; SCOPUS WOS scopus
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 (Î = 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. © 2010 Crohns & Colitis Foundation of America, Inc.
DOI
10.1002/ibd.21490
Appears in Collections:
의과대학 > 의학과 > Journal papers
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