臺大醫院;臺大醫院-內科部;臺大醫院-創傷醫學部;臺大醫院新竹分院;臺大醫院-檢驗醫學部;Keng, Li-TaLi-TaKengShu, Chin-ChungChin-ChungShuChen, Jason Yao-PingJason Yao-PingChenLiang, Sheng-KaiSheng-KaiLiangLin, Ching-KaiChing-KaiLinChang, Lih-YuLih-YuChangChang, Chia-HaoChia-HaoChangWang, Jann-YuanJann-YuanWangYu, Chong-JenChong-JenYuLee, Li-NaLi-NaLee2014-02-142018-07-112014-02-142018-07-112013http://ntur.lib.ntu.edu.tw//handle/246246/259612Objective: Conventional methods for diagnosing tuberculous pleurisy (TB pleurisy) are either invasive or have a long turn-around-time. Performances of pleural adenosine deaminase (ADA), ADA2, interferon-gamma (IFN-gamma), and interferon-gamma release assays (IGRA) as diagnostic tools for TB pleurisy were evaluated. Methods: Eighty-eight patients with lymphocyte-predominant pleural exudates between June 2010 and March 2011, including 31 with clinically diagnosed TB pleurisy, were prospectively studied. Pleural ADA and ADA2 activity were measured by colorimetric method, IFN-gamma levels by enzyme-linked immuno-sorbent assay, and IGRA by enzyme-linked immuno-spot (T-SPOT.TB) assay. Results: Pleural ADA, ADA2, and IFN-gamma levels, but not the proportion of positive T-SPOT.TB assay, were significantly higher in patients with TB pleurisy than in those without TB pleurisy. The area under the receiver-operating-characteristic (ROC) curve was 0.920, 0.893, 0.875, and 0.544 for IFN-gamma, ADA2, ADA, and T-SPOT.TB assay, respectively. The combination of ADA >= 40 IU/L and IFN-gamma >= 75 pg/mL yielded a specificity of 100%. Conclusions: Pleural ADA, ADA2 and IFN-gamma, but not T-SPOT.TB assay, are all sensitive and specific for TB pleurisy. In patients with lymphocyte-predominant pleural exudates, ADA >= 40 IU/L and IFN-gamma >= 75 pg/mL in pleural effusion imply a very high probability of TB pleurisy. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.108 bytestext/htmlAdenosine deaminaseAdenosine deaminase 2Interferon-gammaInterferon-gamma release assayTuberculous pleurisyT-SPOT.TB assayEvaluating pleural ADA, ADA2, IFN-gamma and IGRA for diagnosing tuberculous pleurisyhttp://ntur.lib.ntu.edu.tw/bitstream/246246/259612/1/index.html