title: Diagnostic performance of T-SPOT.TB for extrapulmonary tuberculosis according to the site of infection.
abstract: BACKGROUND
  The clinical manifestations of extrapulmonary tuberculosis (E-TB) vary according to site of disease, so we tested the hypothesis that IFN-γ producing T-cell responses also vary in parallel. Therefore we conducted a prospective, blinded, observational study to evaluate the diagnostic performance of blood T-SPOT.TB according to the various sites of E-TB.
  
  
  METHODS
  From April 2008 to August 2010, all patients with suspected E-TB were enrolled at a tertiary hospital in an intermediate TB-burden country. Final diagnosis in patients with suspected E-TB was classified by clinical category.
  
  
  RESULTS
  A total of 368 patients with suspected E-TB were enrolled; 196 (53%) were classified as having TB, including 119 (32%) with confirmed TB, 34 (9%) probable TB, and 43 (12%) possible TB; the remaining 172 (47%) were classified as not having TB. After excluding patients with possible TB, the T-SPOT.TB was more sensitive in patients with chronic forms of E-TB such as lymph node or osteoarticular TB (93%, 95% CI 83%-97%) than in patients with acute forms of E-TB such as TB meningitis or miliary TB (79%, 95% CI 66%-87%, P = 0.03).
  
  
  CONCLUSIONS
  The diagnostic performance of the blood T-SPOT.TB differs among patients with various clinical manifestations of E-TB.
authors.affiliation: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Oh-Hyun
authors.initials: OH
authors.lastname: Cho
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Sun-Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Song Mi
authors.initials: SM
authors.lastname: Moon
authors.forename: Yong Phil
authors.initials: YP
authors.lastname: Chong
authors.forename: Heungsup
authors.initials: H
authors.lastname: Sung
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Jeong
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung-Han
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011446:Prospective Studies; D056910:Republic of Korea; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000378:metabolism*; D014376:Tuberculosis / Q000175:diagnosis*
chemical_list: D000942:Antigens, Bacterial; D007371:Interferon-gamma