Biological markers in the diagnosis of tuberculous pleural effusion. 2017

Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
Équipe mobile de microbiologie clinique, Laboratoire de microbiologie, Groupe-Hospitalier Paris Saint Joseph, Paris, France.

Tuberculosis is one of the main etiologies to evoke in the context of lymphocyte pleurisy. However, diagnosis is difficult and is based on mycobacteriology that is not enough sensitive and time-consuming, or on histology that requires invasive biopsy gesture. This literature review, carried out from Medline, summarizes the main meta-analyzes, reviews, and originator publications in English on biomarkers, classic and more innovative, studied for the diagnosis of tuberculous pleurisy. Among the immuno-biochemical markers, interferon-γ (IFN-γ), isoenzyme of adenosine deaminase 2 (ADA2) and total adenosine deaminase (ADA) seem the most relevant with respective sensitivities of 89% (87-91), 97.2% (95 to 98.7) and 92% (90-93) and specificities of 97% (96-98), 94.2% (91.8 to 96) and 90% (89-91). About molecular biology, PCR Xpert MTB/RIF has a sensitivity of 46.4% (26.3 to 67.8), which is much higher than the direct examination, while providing rapid diagnostic confirmation, with a specificity of 99.1% (95.2 to 99.8), and a resistance to rifampicin screening. The release assay of interferon-γ (IGRA) is less effective with a sensitivity of 75% (69-81) and a specificity of 82% (75-88) in blood and a sensitivity of 80% (74-86%) and a specificity of 72% (64-80) in pleural fluid. Other biomarkers (including several cytokines) might have an interest but are still under evaluation. These innovative methods, particularly the determination of ADA and the use of PCR Xpert MTB/RIF should find their place in the diagnostic algorithm of TB pleurisy.

UI MeSH Term Description Entries
D010996 Pleural Effusion Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. Effusion, Pleural,Effusions, Pleural,Pleural Effusions
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014396 Tuberculosis, Pleural Tuberculosis of the serous membrane lining the thoracic cavity and surrounding the lungs. Pleurisy, Tuberculous,Pleural Tuberculoses,Pleural Tuberculosis,Pleurisies, Tuberculous,Tuberculoses, Pleural,Tuberculous Pleurisies,Tuberculous Pleurisy
D015415 Biomarkers Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, ENVIRONMENTAL EXPOSURE and its effects, disease diagnosis; METABOLIC PROCESSES; SUBSTANCE ABUSE; PREGNANCY; cell line development; EPIDEMIOLOGIC STUDIES; etc. Biochemical Markers,Biological Markers,Biomarker,Clinical Markers,Immunologic Markers,Laboratory Markers,Markers, Biochemical,Markers, Biological,Markers, Clinical,Markers, Immunologic,Markers, Laboratory,Markers, Serum,Markers, Surrogate,Markers, Viral,Serum Markers,Surrogate Markers,Viral Markers,Biochemical Marker,Biologic Marker,Biologic Markers,Clinical Marker,Immune Marker,Immune Markers,Immunologic Marker,Laboratory Marker,Marker, Biochemical,Marker, Biological,Marker, Clinical,Marker, Immunologic,Marker, Laboratory,Marker, Serum,Marker, Surrogate,Serum Marker,Surrogate End Point,Surrogate End Points,Surrogate Endpoint,Surrogate Endpoints,Surrogate Marker,Viral Marker,Biological Marker,End Point, Surrogate,End Points, Surrogate,Endpoint, Surrogate,Endpoints, Surrogate,Marker, Biologic,Marker, Immune,Marker, Viral,Markers, Biologic,Markers, Immune
D019937 Diagnostic Techniques and Procedures Methods, procedures, and tests performed to diagnose disease, disordered function, or disability. Diagnostic Testing,Diagnostic Technics and Procedures,Technics and Procedures, Diagnostic,Techniques and Procedures, Diagnostic,Testing, Diagnostic

Related Publications

Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
December 2017, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
January 1999, The Indian journal of chest diseases & allied sciences,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
February 1989, Pneumologie (Stuttgart, Germany),
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
January 1959, British journal of diseases of the chest,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
August 2019, Expert review of respiratory medicine,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
February 1996, Revista clinica espanola,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
January 1988, Cancer,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
June 1988, Kekkaku : [Tuberculosis],
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
August 2001, Chest,
Bastien Mollo, and Stéphane Jouveshomme, and François Philippart, and Benoît Pilmis
August 2019, Annals of translational medicine,
Copied contents to your clipboard!