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R. Gineys, S. Trad, C. Terrada, N. Cassoux, J.-C. Piette, P. Le-Hoang, P. Le-Hoang, B. Bodaghi; Interest of an Interferon-Gamma Release Assay For Diagnosing Tuberculosis-Related Ocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5538.
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Tuberculosis-related ocular inflammation diagnosis can be difficult to achieve. Tuberculin skin test (TST) results are not definitive and the workup for coexistent active pulmonary infection is seldom rewarding. Quantiferon-TB test is an Interferon-gamma release assay blood test now currently available for tuberculosis diagnosis.
We made a comprehensive review of the charts of the patients who had had a Quantiferon-TB test from January to October 2007, at the Ophthalmology department at Pitié-Salpêtrière Hospital (Paris, France). We collected the following data: sex, age, infectious medical history, the type of ocular inflammation, TST results, Quantiferon-TB results. We excluded all patients who had previously been fully treated for tuberculosis infection either proved or suspected.
The study included 96 patients. Mean age at presentation was 51 years (22-88, SD=17), with a F/M ratio of 60.1%. Patients presented with various types of uveitis (33 panuveitis, 13 anterior, 14 intermediate, 12 both anterior and intermediate and 16 posterior uveitis) and scleritis (9 cases). There was a bilateral involvement in 56 cases. Quantiferon-TB test was negative in 51 cases, 33 with negative TST, 9 with positive TST and 9 with no TST result available. It was positive in 41 cases, 25 with positive TST, 12 with negative TST and 4 with unavailable TST result. Finally, 4 Quantiferon-TB test results remained undertermined, 2 with negative TST, one positive and one unavailable.
Quantiferon is a simple ancillary test, when available in the laboratory. It appears to be helpful, along with TST, to identify patients with tuberculosis, whatever their vaccinal status is. Nevertheless, discordant results exist between the two tests. Collaboration with internal medicine physicians helped us to decide further antituberculous therapy. We agreed to treat all patients with a positive Quantiferon-TB test, especillay if systemic corticosteroids or immunosuppressors are necessary.
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