| 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 |
Related Documents
:
|
2277973 - Upper gastrointestinal manifestations in rheumatoid arthritis patients: intrinsic or ex... 17287933 - Association of bone mineral density and vertebral deformity in patients with rheumatoid... 22580253 - Percutaneous closure of atrial right-to-left shunt in patients with ebstein's anomaly o... |
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. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| 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
Previous Document: Bacterial dissimilatory MnO(2) reduction at extremely haloalkaline conditions.
Next Document: Lack of association between endothelial constitutive nitric oxide synthase (ecNOS 4 b/a) gene polymo...