title: [Pleural fluid interferon-gamma (IFN-gamma) measurement as a diagnostic tool in tuberculous pleurisy].
abstract: BACKGROUND
  Tuberculosis is one of the most common causes of pleural effusion (PE). However, the diagnosis of tuberculous pleurisy still remains difficult. Since M. tuberculosis isolation rates in tuberculous effusions are relatively low the histological and microbiological studies of pleural biopsy samples are usually required to confirm the diagnosis. Several biological markers have been proposed to enhance the effectiveness of diagnosing patients with tuberculous pleurisy. The study was undertaken to evaluate the diagnostic accuracy of pleural fluid IFN-gamma concentration in differentiation between tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (nTPE).
  
  
  METHODS
  94 patients (50 M and 44 F, mean age 59 +/- 18, range 18-95 years) with PE were studied. All subjects underwent diagnostic thoracentesis and extensive laboratory pleural fluid evaluation. Tuberculous pleural effusion was diagnosed in: 1) patients with positive pleural fluid or pleural biopsy culture and 2) patients with granulomas in the pleural biopsy specimen, after exclusion of other granulomatous diseases. IFN-gamma level in pleural fluid was measured with commercially available immunoenzymatic assay (Quantikine Human IFN-gamma Immunoassay, R&D Systems, USA).
  
  
  RESULTS
  Tuberculous pleural effusion was diagnosed in 28 pts. The non-tuberculous pleural effusion group consisted of 66 pts, including 35 with malignant PE, 20 with parapneumonic effusion or pleural empyema, 5 with pleural transudates due to heart failure, and 6 with miscellaneous causes of PE. The mean concentration of IFN-g was significantly higher in TPE than in nTPE (614.1 +/- 324.5 vs. 15.1 +/- 36.0 pg/ml, p < 0.0001). At the cut-off value of 100 pg/ml the sensitivity and specificity of the test were 100% and 98,5% respectively.
  
  
  CONCLUSIONS
  The pleural fluid concentration of IFN-gamma was found to be highly sensitive and specific marker of tuberculous pleurisy.
authors.affiliation: Katedra i Klinika Chorób Wewnetrzynch, Pneumonologii i Alergologii UM w Warszawie, ul. Banacha 1A, Warsaw. rafalkrenke@interia.pl
authors.forename: Rafał
authors.initials: R
authors.lastname: Krenke
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Safianowska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Paplińska
authors.forename: Piotr
authors.initials: P
authors.lastname: Korczyński
authors.forename: Barbara
authors.initials: B
authors.lastname: Dmowska-Sobstyl
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Bogacka-Zatorska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Jaworski
authors.forename: Ryszarda
authors.initials: R
authors.lastname: Chazan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology; D011044:Poland; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000175:diagnosis*; D014397:Tuberculosis, Pulmonary / Q000150:complications
chemical_list: D015415:Biomarkers; D007371:Interferon-gamma