The value of interferon gamma release assays in the diagnosis of tuberculous meningitis in children / 临床儿科杂志

ABSTRACT

ObjectiveTo investigate the diagnostic value of interferon gamma release assays (IGRAs) in children with tuberculous meningitis.MethodsThe prospective case-control study was applied. From January 2012 to March 2013, 32 children diagnosed with tuberculous meningitis (TBM group) and 30 children diagnosed with non-tuberculous meningitis (non-TBM group) were recruited. The positive rates of the interferon gamma release assays (IGRAs), tuberculin skin test (TST), mycobacterium tuberculosis antibody test (TB-IgG), cerebrospinal lfuid of mycobacterium tuberculosis DNA test (TB-DNA), and the sensitivity, speciifcity, negative and positive predictive value of all these tests were compared between TBM group and non-TBM group.Results The positive rate of IGRAs, TST, TB-IgG, and TB-DNA was 87.50%, 56.25%, 46.88% and 34.38%respectively in TBM group, and 6.67%, 23.33%, 20% and 0% respectively in non-TBM group. The differences were statistically signiifcant (P<0.05). The sensitivity of IGRAs, TST, TB-IgG, and TB-DNA was 87.5%, 56.25%, 6.88% and 34.38% respectively. The speciifcity of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 76.67%, 80.00% and 100% respectively. The differences of sensitivity and speciifcity were statistically signiifcant (P<0.05). The sensitivity of IGRAs was higher than that of other tests (P<0.017). The positive predictive value of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 72%, 71.43% and 100% respec-tively. The negative predictive value was 87.50%, 62.16%, 58.54% and 58.82% respectively.Conclusions IGRAs, TST, TB-IgG, and TB-DNA are valuable in the diagnosis of tuberculous meningitis. IGRAs has a relatively higher sensitivity and speciifcity.