Clinical Diagnostic Utility of IP-10 and LAM Antigen Levels for the Diagnosis of Tuberculous Pleural Effusions in a High Burden Setting
2009

Diagnosing Tuberculous Pleural Effusions with IP-10 and LAM Antigen Levels

Sample size: 74 publication Evidence: moderate

Author Information

Author(s): Dheda Keertan, Van-Zyl Smit Richard N., Sechi Leonardo A., Badri Motasim, Meldau Richard, Symons Gregory, Khalfey Hoosein, Carr Igshaan, Maredza Alice, Dawson Rodney, Wainright Helen, Whitelaw Andrew, Bateman Eric D., Zumla Alimuddin

Primary Institution: University of Cape Town, Cape Town, South Africa

Hypothesis

The study investigates the diagnostic utility of IP-10 and LAM antigen levels for tuberculous pleural effusions in a high burden setting.

Conclusion

IP-10 may be a useful rule-out test for tuberculous pleural effusions, but larger studies are needed to confirm these findings.

Supporting Evidence

  • IP-10 levels were significantly higher in TB vs non-TB participants.
  • ADA showed high sensitivity but sub-optimal specificity.
  • NAAT had poor sensitivity but high specificity.
  • LAM antigen detection was not diagnostically useful.

Takeaway

Doctors are trying to find better ways to tell if someone has tuberculosis in their lungs by testing for certain proteins in fluid from around the lungs.

Methodology

The study compared the diagnostic utility of ADA, NAAT, IP-10 levels, and LAM antigen detection in pleural effusions from 78 tuberculosis suspects.

Potential Biases

Potential bias due to the study being conducted in a single high burden setting.

Limitations

The sample size was small, and results may not be generalizable to low burden settings.

Participant Demographics

Participants were South African tuberculosis suspects, with a mean age of 37 years, and 49% were HIV positive.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1371/journal.pone.0004689

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