PT  - JOURNAL ARTICLE
AU  - M. Losi
AU  - A. Bossink
AU  - L. Codecasa
AU  - C. Jafari
AU  - M. Ernst
AU  - S. Thijsen
AU  - D. Cirillo
AU  - M. Ferrarese
AU  - U. Greinert
AU  - L. M. Fabbri
AU  - L. Richeldi
AU  - C. Lange
ED  - ,
TI  - Use of a T-cell interferon-γ release assay for the diagnosis of tuberculous pleurisy
AID  - 10.1183/09031936.00067307
DP  - 2007 Dec 01
TA  - European Respiratory Journal
PG  - 1173--1179
VI  - 30
IP  - 6
4099  - http://erj.ersjournals.com/content/30/6/1173.short
4100  - http://erj.ersjournals.com/content/30/6/1173.full
SO  - Eur Respir J2007 Dec 01; 30
AB  - The diagnosis of pleural tuberculosis (plTB) by the analysis of pleural effusions (PEs) with standard diagnostic tools is difficult. In routine clinical practice, the present authors evaluated the performance of a commercially available Mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot assay on peripheral blood mononuclear cells (PBMCs) and pleural effusion mononuclear cells (PEMCs) in patients with suspect plTB. The T-SPOT.TB test (Oxford Immunotec Ltd, Abingdon, UK) was performed on PBMCs and PEMCs in 20 patients with a clinical and radiological suspect of plTB and in 21 control subjects with a diagnosis of PE of nontuberculous origin at four centres participating in the European Tuberculosis Network. In total, 18 (90%) out of 20 patients with plTB tested T-SPOT.TB-positive on PBMCs and 19 (95%) out of 20 on PEMCs. Among controls, T-SPOT.TB was positive in seven out of 21 (33%) patients when performed on PBMCs (these patients were assumed to be latently infected with MTB) and five (23%) out of 21 when performed on PEMCs. Sensitivity and specificity of T-SPOT.TB for the diagnosis of active plTB when performed on PEMCs were 95 and 76%, respectively. Enumerating Mycobacterium tuberculosis-specific T-cells in pleural effusion mononuclear cells by ELISPOT is feasible in routine clinical practice and may be useful for a rapid and accurate diagnosis of pleural tuberculosis.