title: [Interferon-gamma release assays for hospital-based tuberculosis diagnostics in children and adolescents--a retrospective analysis].
abstract: OBJECTIVE
  Interferon-gamma release assays (IGRA) are well established for diagnosing latent tuberculosis infection in adults. Evidence for their diagnostic relevance in children is still insufficient. The aim of this study was to evaluate the sensitivity and specificity of IGRA compared to the tuberculin skin test (TST) in a local population of children and adolescents presenting to our lung clinic with a specialised outpatient department.
  
  
  METHODS
  Records from all patients evaluated for tuberculosis at our centre between 2009 and 2011 were analysed retrospectively. Complete data sets were available for 80 children and adolescents (age 3 months to 17 years) in the following diagnostic groups: active pulmonary tuberculosis (MTB, n = 13), latent tuberculosis infection (LTBI, n = 15) and controls with tuberculosis exposure (n = 40), non-tuberculous mycobacterial disease (NTM, n = 2) or other lung diseases (n = 10).
  
  
  RESULTS
  All 13 patients with MTB were positive on both IGRA and TST. Among the LTBI patients, 14 /15 had a positive IGRA and 14 /15 a positive TST result. In the control group 0 /52 exceeded the IGRA cut-off, while three patients had a positive TST due to a cross reaction with BCG or NTM.
  
  
  CONCLUSIONS
  IGRA and TST results are highly correlated in paediatric patients with active or latent tuberculosis. IGRA sensitivity was comparable to that of the TST with a higher specificity as expected. The importance of IGRA in the hospital setting to guide diagnostic algorithms in an unselected population should be further evaluated in prospective studies.
authors.affiliation: Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Walterhöferstrasse 11, Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Knappik
authors.forename: N
authors.initials: N
authors.lastname: Schönfeld
authors.forename: A
authors.initials: A
authors.lastname: Günther
authors.forename: T
authors.initials: T
authors.lastname: Bergmann
authors.forename: K
authors.initials: K
authors.lastname: Magdorf
authors.forename: H
authors.initials: H
authors.lastname: Rüssmann
authors.forename: H
authors.initials: H
authors.lastname: Mauch
authors.forename: M
authors.initials: M
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000097:blood*; D059425:Interferon-gamma Release Tests / Q000379:methods*; D055985:Latent Tuberculosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014374:Tuberculin Test / Q000379:methods*
chemical_list: D015415:Biomarkers; D007371:Interferon-gamma