›› 2015, Vol. 33 ›› Issue (3): 242-.doi: 10.3969j.issn.1000-3606.2015.03.011

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The value of interferon gamma release assays in the diagnosis of tuberculous meningitis in children

MU Faguang1, HE Hailan1, TAN Taichang2, LI Yi3   

  1. 1. Department of Pediatrics, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China; 2. Laboratory of Immunology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China; 3. Department of Pediatrics, People's Hospital of Aba Prefecture of Sichuan Province, Barkam 624000, Sichuan, China
  • Received:2015-03-15 Online:2015-03-15 Published:2015-03-15

Abstract: Objective To investigate the diagnostic value of interferon gamma release assays (IGRAs) in children
with tuberculous meningitis.  Methods  The prospective case-control study was applied. From January 2012 to March 2013,
32 children diagnosed with tuberculous meningitis (TBM group) and 30 children diagnosed with non-tuberculous meningitis (non-TBM group) were recruited. The positive rates of the interferon gamma release assays (IGRAs), tuberculin skin test (TST), mycobacterium tuberculosis antibody test (TB-IgG), cerebrospinal fluid of mycobacterium tuberculosis DNA test (TB-DNA), and the sensitivity, specificity, negative and positive predictive value of all these tests were compared between TBM group and non-TBM group. Results  The positive rate of IGRAs, TST, TB-IgG, and TB-DNA was 87.50%, 56.25%, 46.88% and 34.38% respectively in TBM group, and 6.67%, 23.33%, 20% and 0% respectively in non-TBM group. The differences were statistically significant (P<0.05). The sensitivity of IGRAs, TST, TB-IgG, and TB-DNA was 87.5%, 56.25%, 6.88% and 34.38% respectively. The specificity of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 76.67%, 80.00% and 100% respectively. The differences of sensitivity and specificity were statistically significant (P<0.05). The sensitivity of IGRAs was higher than that of other tests (P<0.017). The positive predictive value of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 72%, 71.43% and 100% respectively. The negative predictive value was 87.50%, 62.16%, 58.54% and 58.82% respectively. Conclusions  IGRAs, TST, TB-IgG, and TB-DNA are valuable in the diagnosis of tuberculous meningitis. IGRAs has a relatively higher sensitivity and specificity.