title: QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation.
abstract: OBJECTIVE
  To evaluate the accuracy of QuantiFERON-TB Gold testing in patients with presumptive tuberculosis-ocular inflammation.
  
  
  METHODS
  Prospective nonrandomized case series and clinical laboratory investigation.
  
  
  METHODS
  Ninety-six consecutive patients presenting with ocular inflammation between January and October 2007 were tested using QuantiFERON-TB Gold. Positive patients received a 6-month anti-tuberculosis treatment. Patient follow-up ranged from 12 months to 24 months. Treatment was considered effective at the end of follow-up, in cases of no or a 2-point decrease of ocular inflammation (SUN criteria) and systemic corticosteroids stopped or tapered to 10 mg/day.
  
  
  RESULTS
  Mean age was 51 ± 17 years. Types of ocular inflammation included scleritis (n = 7), panuveitis (n = 34), and posterior (n = 15), intermediate (n = 14), and anterior uveitis (n = 15). QuantiFERON-TB Gold was positive in 42 cases (44%), negative in 51 cases (53%), and undetermined in 3 cases (3%). Among positive QuantiFERON-TB Gold patients, 25 received a full anti-tuberculosis treatment, which was effective in 15 cases (60%). Associated systemic steroids were given to 6 patients and tapered to 10 mg/day or less in all cases. Median QuantiFERON-TB Gold value was significantly higher in the group with a successful therapeutic response (7.67 IU/mL [0.46 to 33.37]) compared to the group with treatment failure (1.22 IU/mL [0.61 to 4.4]), P = .026.
  
  
  CONCLUSIONS
  Results of anti-tuberculosis treatment were encouraging in QuantiFERON-TB Gold-positive ocular inflammation, especially with values over 2 IU/mL in our study, suggesting that a higher cut-off value than that given by the manufacturer should be considered to better identify ocular inflammation that can benefit from full anti-tuberculosis treatment.
authors.affiliation: Service d'Ophtalmologie, CHNO des Quinze-Vingts, Paris, France.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gineys
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Pitié-Salpêtrière, Paris, France. Electronic address: bahram.bodaghi@psl.aphp.fr.
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
authors.affiliation: Laboratoire d'Immunologie Tissulaire et Cellulaire, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Carcelain
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cassoux
authors.affiliation: Inserm U945; Service de Médecine Interne, Hôpital de la Pitie-Salpêtriere, Paris, France.
authors.forename: Le Thi Huong
authors.initials: LTH
authors.lastname: Boutin
authors.affiliation: Inserm U945; Service de Médecine Interne, Hôpital de la Pitie-Salpêtriere, Paris, France.
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
authors.forename: Phuc
authors.initials: P
authors.lastname: Lehoang
authors.affiliation: Hôpital Ambroise Paré, Service de Médecine Interne, Boulogne-Billancourt, France.
authors.forename: Salim
authors.initials: S
authors.lastname: Trad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D015423:Scleritis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D014605:Uveitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D005938:Glucocorticoids; D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma