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The use of positron emission tomography/CT in the diagnosis of tuberculosis-associated uveitis.
MedLine Citation:
PMID:  20935307     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background Detection of tuberculosis as the underlying disease in uveitis can be problematic because of the limited sensitivity of conventional diagnostic methods, especially in the case of latent infection. The aim of our study was to evaluate the clinical usefulness of (18)F-fluorodeoxyglucose positron emission tomography/CT ((18)F-FDG-PET/CT) in patients with uveitis and positive interferon-γ release assay. Methods We screened 95 patients with different uveitis forms by QuantiFERON TB-Gold test. Positive results were found in 24 cases. (18)F-FDG-PET/CT was performed in 20 QuantiFERON-positive patients. PET/CT images were evaluated for the presence, size and metabolic activity of hilar and mediastinal lymph nodes and pulmonary lesions. Results In nine patients (45%) PET/CT detected increased FDG uptake in mediastinal or hilar lymph nodes. In two patients Mycobacterium tuberculosis was detected in culture after PET/CT-guided lymph node biopsy. In seven patients (35%) with serpiginous choroiditis partly calcified lymph nodes without FDG-uptake were found. Remission of uveitis was achieved in nine of 11 (82%) anti-tuberculosis-treated patients with progressive course of uveitis. Conclusion In QuantiFERON-positive patients with severe uveitis forms, such as serpiginous choroiditis and occlusive retinal vasculitis, (18)F-FDG-PET/CT is useful to identify lesions appropriate for biopsy and helps to establish the diagnosis and appropriate therapy for presumed tuberculosis-induced intraocular inflammation.
Authors:
Deshka Doycheva; Christoph Deuter; Juergen Hetzel; Julia-Stefanie Frick; Phillip Aschoff; Eva Schuelen; Manfred Zierhut; Christina Pfannenberg
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Publication Detail:
Type:  Journal Article     Date:  2010-10-08
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  95     ISSN:  1468-2079     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1290-4     Citation Subset:  IM    
Affiliation:
Centre for Ophthalmology, University of Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany; deshka.doycheva@med.uni-tuebingen.de.
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