Journal List > Lab Med Online > v.4(2) > 1057234

Park, Park, Ki, Lee, Chang, and Kang: Interferon-γ Release Assay Using Pericardial Fluid and Peripheral Blood for the Diagnosis of Tuberculous Pericarditis: A Case Report

Abstract

Here, we report a case in which the rapid diagnosis of tuberculous pericarditis was made using Mycobacterium tuberculosis (MTB)-specific interferon-γ release assay on peripheral blood and pericardial effusion. Acid-fast bacilli staining, mycobacterial culture, and nucleic acid amplification targeting MTB using pericardial fluid were negative. However, elevated adenosine deaminase (ADA) activity in pericardial fluid and interferon-γ release assay positivity in both pericardial fluid and peripheral blood indicated the presence of tuberculous pericarditis. After anti-tuberculous and steroid treatment, the patient's clinical symptoms improved, and pericardial effusion has not reoccurred.

Figures and Tables

Fig. 1
Predominance of lymphocytes in pericardial effusion (Wright stain, 400×).
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Fig. 2
T-SPOT TB results performed with cellular component of pericardial effusion. (A) Negative control (stimulated with medium alone). (B) Positive control (stimulated with phytohemagglutinin). (C) ESAT-6 (stimulated with MTB-specific peptides ESAT-6). (D) CFP-10 (stimulated with MTB-specific peptides CFP-10).
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Table 1
Laboratory results at admission
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Abbreviations: WBC, white blood cells; PMN, polymorphonuclear leukocytes; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, blood urea nitrogen; LD, lactate dehydrogenase; CK, creatine kinase; cTnI, cardiac troponin I; NT-proBNP, N-terminal probrain natriuretic peptide; RBC, red blood cells.

Table 2
Mycobacterium tuberculosis-specific interferon-γ release assay results
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*Test results of QFT-GIT and T-SPOT TB were interpreted according to the manufacturers' guidelines.

Abbreviations: QFT-GIT, QuantiFERON-TB Gold in-tube (Cellestis, Carnegie, Australia); T-SPOT, T-SPOT TB (Oxford Immunotec, Abingdon, UK); ESAT-6, early secretory antigenic target 6; CFP-10, culture filtrate protein 10; SFU, spot forming unit; ISL, no. of IFN-γ secreting lymphocytes/106 lymphocytes in pericardial fluid.

Notes

This article is available from http://www.labmedonline.org

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