Initial Results of QuantiFERON-TB Gold Testing in Patients With Uveitis

Abstract

Purpose: : Tuberculosis infection is important to detect in patients with ophthalmologic disease because it is a treatable form of uveitis. The QuantiFERON-TB Gold (QFT-G) test is a blood test which uses enzyme-linked immunosorbent assay (ELISA) to detect interferon gamma released by T-cells with prior exposure to M. tuberculosis. It appears to be more sensitive for the detection of tuberculosis even in the presence of prior Bacillus Calmette-Guérin (BCG) vaccination. We describe the use in a series of patients in an ophthalmic practice.

Methods: : The charts of all patients who had QFT-G tests ordered by Mayo Clinic ophthalmologists in the past three years were reviewed.

Results: : Twenty seven QFT-G tests were ordered. Fourteen (52%) tests were negative, six (22%) were indeterminate, and two (7%) tests were re-ordered after a lab accident or an improper cancellation, and five (19%) were positive. Of the six positive cases, three were treated for tuberculosis: one had tubeculous iritis, one had retinal vasculitis and haemorrhage and one had asymptomatic tuberculosis but was on immunosuppressive therapy.

Conclusions: : In a series of selected patients with uveitis, the QFT-G test was able to detect tuberculosis infection in 22% of the patients. QFT-G should be considered instead of PPD testing in cases of uveitis or at least in those with uveitis that have had prior BCG vaccination.

Keywords: uveitis-clinical/animal model • clinical laboratory testing • inflammation