Document Detail


Usefulness and limitations of QuantiFERON-TB Gold in Japanese rheumatoid arthritis patients: proposal to decrease the lower cutoff level for assessing latent tuberculosis infection.
MedLine Citation:
PMID:  19779763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to determine the sensitivity and specificity of QuantiFERON-TB Gold (QFT-G) in Japanese rheumatoid arthritis (RA) patients with a past history of tuberculosis (TB). We assessed whether it is possible to decrease the cutoff using receiver operating characteristic (ROC) analysis. We evaluated chest computed tomography (CT) findings, prior history of treatment, and contact with active TB in 370 RA patients. Forty-nine patients before initiation of treatment with tumor necrosis factor (TNF) inhibitors were divided into two groups: 22 with a past history of TB and 27 without. We estimated the efficacy of QFT-G compared with the tuberculin skin test and antituberculosis (anti-TB) glycolipid antigen antibody. QFT-G was positive (>or=0.35 IU/ml) in 13.6% with a past history of TB, increasing to 27.3% at the intermediate range cutoff of 0.1 IU/ml. The sensitivity and specificity of QFT-G was 0.27 and 1.00, respectively, at 0.1 IU/ml. Using ROC analysis, the area under the curve (AUC) of QFT-G but not for the other two tests was significantly large. QFT-G is a useful diagnostic method due to its superior specificity, but the use of a cutoff value of 0.35 IU/ml will likely result in an underestimate. We propose that a lower interferon-gamma (IFN-gamma) titer of 0.1 IU/ml be adopted when deciding to administer anti-TB drugs before initiation of TNF inhibitors.
Authors:
Tomoyo Maeda; Shogo Banno; Shinji Maeda; Taio Naniwa; Yoshihito Hayami; Maiko Watanabe; Rei Itoh; Shigeki Sato; Ryuzo Ueda
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-09-25
Journal Detail:
Title:  Modern rheumatology / the Japan Rheumatism Association     Volume:  20     ISSN:  1439-7609     ISO Abbreviation:  Mod Rheumatol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100959226     Medline TA:  Mod Rheumatol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  18-23     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Science, Nagoya, Aichi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antigens, Bacterial / immunology
Arthritis, Rheumatoid / blood,  complications,  pathology*
Female
Humans
Interferon-gamma / blood*
Latent Tuberculosis / blood,  complications,  diagnosis*
Male
Middle Aged
Mycobacterium tuberculosis / immunology,  isolation & purification*
Predictive Value of Tests
ROC Curve
Reagent Kits, Diagnostic
Tuberculin Test
Tuberculosis, Pulmonary / blood,  complications,  diagnosis*
Chemical
Reg. No./Substance:
0/Antigens, Bacterial; 0/Reagent Kits, Diagnostic; 82115-62-6/Interferon-gamma

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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