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Diagnostic value of interleukin-12 p40 in tuberculous pleural effusions

¹ Pulmonology Service, and ² Clinical Analysis Service, Complejo Hospitalario Clínico Universitario de Santiago, Santiago de Compostela, Spain.

CORRESPONDENCE: L. Valdés, Servicio de Neumología, Hospital de Conxo, Complejo Hospitalario Clínico Universitario de Santiago, Rúa Dr Ramón Baltar s/n, 15706 Santiago de Compostela, A Coruña, Spain. Fax: 34 981531255. E-mail: luis.valdes.cuadrado{at}sergas.es

Keywords: Interleukin, pleural effusion, tuberculosis

Received: June 5, 2008
Accepted November 10, 2008

The diagnosis of tuberculous pleural effusion (TBPE) is frequently problematic. Several markers of TBPE in pleural fluid have been evaluated, with different results.

Pleural effusions from 96 patients were classified on the basis of definitive diagnosis as tuberculous (n = 39), neoplastic (n = 42) or parapneumonic (n = 15). Adenosine deaminase (ADA), ADA isoform ADA-2, interferon (IFN)-, CD3⁺/DR⁺ T-lymphocytes and interleukin (IL)-12 p40 were determined in all 96 effusions. The efficiency of IL-12 p40 for diagnosis of TBPEs was evaluated, in comparison with those of the other parameters, by comparing the areas under their receiver operating characteristics.

With the threshold value of 550 pg·mL^–1, IL-12 p40 had a sensitivity of 92.3% (36 out of 39) and specificity of 70.2% (17 false positives). The misclassification rate of IL-12 p40 was significantly greater than those of ADA-2 and ADA. Among TBPEs, ADA correlated significantly with ADA-2, and IFN- with ADA and IL-12 p40.

Although tuberculous pleural effusions show values of interleukin-12 p40 that are significantly higher than neoplastic and parapneumonic fluids, this parameter is less efficient than adenosine deaminase, adenosine deaminase isoform 2 and interferon-. Its routine determination is, accordingly, not justified.