Positive predictive value of ELISpot in BAL and pleural fluid from patients with suspected pulmonary tuberculosis

Regina W. Hofland*, Steven F. T. Thijsen, Anne S. R. van Lindert, Wiel C. M. de Lange, Tamara van Gorkom, Ingeborg van der Tweel, Jan-Willem Lammers, Aik W. J. Bossink

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    5 Citaten (Scopus)
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    Background: The aim of this study was to evaluate the positive predictive value (PPV) of ELISpot in bronchoalveolar lavage (BAL) and pleural fluid for the diagnosis of active tuberculosis (TB) in real-life clinical practice, together with the added value of a cut-off >1.0 for the ratio between the extra-sanguineous and systemic interferon-gamma responses in positive samples.

    Methods: A retrospective, single-centre study was performed. Patients with positive ELISpot in BAL and pleural fluid were included.

    Results: The PPV for TB in patients with positive ELISpot in BAL (n = 40) was 64.9%, which increased to 82.6% for the ESAT-6 panel and 71.4% for the CFP-10 panel after the introduction of a cut-off >1.0 for the ratio between the BAL and blood interferon-gamma responses. In patients with positive ELISpot in pleural fluid (n = 16), the PPV for TB was 85.7%, which increased to 91.7% for the ESAT-6 panel and 92.3% for the CFP-10 panel after the introduction of a cut-off >1.0 for the ratio between the pleural fluid and blood interferon-gamma responses.

    Conclusions: This report describes the PPV of ELISpot in BAL and pleural fluid for the diagnosis of active TB in real-life clinical practice. The results indicate the possibility of an increase of the PPV using a cut-off >1.0 for the ratio between the extra-sanguineous and systemic interferon-gamma responses. Further studies are needed to underline this ratio-approach and to evaluate the full diagnostic accuracy of ELISpot in extra-sanguineous fluids like BAL and pleural fluid.

    Originele taal-2English
    Pagina's (van-tot)347-355
    Aantal pagina's9
    TijdschriftACS Infectious Diseases
    Volume49
    Nummer van het tijdschrift5
    DOI's
    StatusPublished - 2017

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