224. Diagnostic Value of Interferon-γ Release Assays on Pericardial Effusion for Diagnosis of Tuberculous Pericarditis
Session: Poster Abstract Session: Diagnostics: Mycobacteriology
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWeek poster-2016BSN.pdf (447.7 kB)
  • Background: Diagnosis of tuberculous pericarditis remains a challenge. We did this study to evaluate the diagnostic value of T-SPOT.TB on pericardial effusion for diagnosis of tuberculous pericarditis.

    Methods: Patients with suspected tuberculous pericarditis were enrolled consecutively between August 2011 and December 2015. T-SPOT.TB was performed on both pericardial effusion mononuclear cells (PEMCs) and peripheral blood mononuclear cells (PBMCs). Sensitivity, specificity, predictive value (PV), and likelihood ratio (LR) of T-SPOT.TB on PEMCs and PBMCs were analyzed.

    Results: Among the 75 patients enrolled, 24 patients (32%) were diagnosed with tuberculous pericarditis, 38 patients (51%) with nontuberculous pericarditis, including solid and hematological malignant tumors in 18 patients (47%), hematological diseases in 2 patients (5%, plasma cell dyscrasia and amyloidosis in one each patient), connective tissue diseases in 5 patients (13%), abnormal structure of thoracic duct leading to chylaceous pericardial effusion in six patients (16%), valvular heart disease in three patients (8%) and others in four patients (10%), and 13 patients (17%) were clinically indeterminate and were excluded from the final analysis. The sensitivity, specificity, positive PV (PPV), negative PV (NPV), positive LR (LR+), negative LR (LR-) of T-SPOT.TB on PEMCs was 92%, 92%, 88%, 95%, 11.61, and 0.09, respectively, compared to 83%, 95%, 91%, 90%, 15.83, and 0.18, respectively of T-SPOT.TB on PBMCs. In patients with tuberculous pericarditis, the median frequencies of spot-forming cells (SFCs) of T-SPOT.TB on PEMCs and PBMCs was 172 SFCs/106MC (IQR 39~486), and 66 SFCs/106MC, (IQR 24~526), respectively, but the difference was not significant (P=0.183).

    Conclusion: T-SPOT.TB on PEMCs appeared to be a valuable tool for diagnosis of tuberculous pericarditis with high sensitivity and specificity.

    Sainan Bian, MA1, Yueqiu Zhang, BA2, Lifan Zhang, MD, PhD2, Xiaochun Shi, MD2 and Xiaoqing Liu, MD1, (1)Peking Union Medical College Hospital, Beijing, China, (2)Division of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China

    Disclosures:

    S. Bian, None

    Y. Zhang, None

    L. Zhang, None

    X. Shi, None

    X. Liu, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.