폐결핵 접촉력을 가진 소아에서 잠복 결핵 감염의 진단을 위한 결핵 특이항원 자극 인터페론-감마 측정의 유용성 (Usefulness of Interferon-γ measurement following stimulation of tuberculosis-sp ecific antig ens for diagnosis of latent tuberculosis infection in children ex posed to pulmonary tuberculosis)

서지정보

· 발행기관 : 대한소아감염학회
· 수록지 정보 : Pediatric Infection and Vaccine / 15권 / 1호 / 51 ~ 57페이지
· 저자명 : 성지연, 김주화, 양미애, 김소희, 은병욱, 김남희, 박경운, 이진아, 최은화, 이환종

초록

Purpose : Whole blood interferon-γ assay was developed and many studies showed its
usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI).
However, assessment in children has been limited. This study was undertaken to evaluate
the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to
pulmonary TB.
Methods : Children who visited Seoul National University Bundang Hospital with a history
of TB exposure were enrolled from January 2006 to December 2007. They were evaluated
with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was
retested 3 months later for those with initial negative reactivity. Definition of LTBI was
made on the basis of the TST reactivity.
Results : Among the 103 children with a history of TB exposure, 49 children were tested
with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age
was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8
(19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold
test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status,
1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The
agreement between the QuantiFERON-TB Gold and the TST was poor (κ=0.101).
Conclus ion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in
children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in
the diagnosis of LTBI in children. (Korean J Pediatr Infect Dis 2008;15:50-57)

영어초록

Purpose : Whole blood interferon-γ assay was developed and many studies showed its
usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI).
However, assessment in children has been limited. This study was undertaken to evaluate
the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to
pulmonary TB.
Methods : Children who visited Seoul National University Bundang Hospital with a history
of TB exposure were enrolled from January 2006 to December 2007. They were evaluated
with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was
retested 3 months later for those with initial negative reactivity. Definition of LTBI was
made on the basis of the TST reactivity.
Results : Among the 103 children with a history of TB exposure, 49 children were tested
with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age
was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8
(19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold
test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status,
1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The
agreement between the QuantiFERON-TB Gold and the TST was poor (κ=0.101).
Conclus ion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in
children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in
the diagnosis of LTBI in children. (Korean J Pediatr Infect Dis 2008;15:50-57)

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