title: Clinical importance of serum neopterin level in patients with pulmonary tuberculosis.
abstract: OBJECTIVE
  Neopterin is a sensitive marker for cell-mediated immune response. Because of this, the neopterin levels of body fluids show cell-mediated immune response in different infectious diseases which involve T cells and macrophages. The aim of this study was to determine the clinical importance of neopterin levels in patients with tuberculosis and compare with those levels of healthy subjects.
  
  
  METHODS
  Seventy patients with tuberculosis (46 newly diagnosed cases, 15 relapse cases, and 9 multidrug-resistant tuberculosis cases) and 18 healthy adult individuals were included in the study. Neopterin concentrations were measured by the ELISA method according to the protocol of the manufacturer. Chi-square test was used in statistical analysis; p⩽0.05 was considered statistically significant.
  
  
  RESULTS
  Serum mean neopterin levels were 23.74±21.8nmol/L (median: 18.3) in newly diagnosed patients with pulmonary tuberculosis; 28.69±21.2nmol/L (median: 21.2) in relapse patients and 31.28±14nmol/L (median: 25.4) in multidrug-resistant tuberculosis cases, respectively. Serum mean neopterin levels were 4.03±5.12nmol/L (median: 5.1) in healthy subjects. The serum neopterin levels were found to be significantly higher in patients with tuberculosis than the control group. There was a statistically significant correlation between neopterin positivity (neopterin level ⩾10nmol/L was accepted to be positive) and clinical symptoms of hemoptysis and weight loss. Besides statistically significant correlations between neopterin positivity and hemoglobin level, sedimentation rate, mean leukocyte count and radiological involvement (localized or diffuse) were determined.
  
  
  CONCLUSIONS
  Serum neopterin levels can be used as a helper laboratory finding for the diagnosis of patients with tuberculosis. For this aim, further controlled studies are needed.
authors.affiliation: Ankara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey. Electronic address: scesur89@yahoo.com.
authors.forename: Salih
authors.initials: S
authors.lastname: Cesur
authors.affiliation: Bezmialem Foundation University School of Medicine, Infectious Diseases and Clinical Microbiology Department, Istanbul, Turkey.
authors.forename: Turan
authors.initials: T
authors.lastname: Aslan
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Diseases Department, Ankara, Turkey.
authors.forename: Nevin Taci
authors.initials: NT
authors.lastname: Hoca
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Diseases Department, Ankara, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Çimen
authors.affiliation: Adıyaman University, Faculty of Medicine, Department of Medical Microbiology, Adıyaman, Turkey.
authors.forename: Gülnur
authors.initials: G
authors.lastname: Tarhan
authors.affiliation: Kırıkkale University, Faculty of Medicine, Department of Internal Medicine, Kırıkkale, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Çifçi
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Microbiology Laboratory, Ankara, Turkey.
authors.forename: İsmail
authors.initials: İ
authors.lastname: Ceyhan
authors.affiliation: Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Diseases Department, Ankara, Turkey.
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Şipit
keywords: Diagnosis; Follow-up; Neopterin; Pulmonary tuberculosis