Lab Med Online.  2014 Apr;4(2):116-121.

Interferon-gamma Release Assay Using Pericardial Fluid and Peripheral Blood for the Diagnosis of Tuberculous Pericarditis: A Case Report

Affiliations
  • 1Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. esk.kang@samsung.com
  • 2Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sunga.chang@samsung.com

Abstract

Here, we report a case in which the rapid diagnosis of tuberculous pericarditis was made using Mycobacterium tuberculosis (MTB)-specific interferon-gamma release assay on peripheral blood and pericardial effusion. Acid-fast bacilli staining, mycobacterial culture, and nucleic acid amplification targeting MTB using pericardial fluid were negative. However, elevated adenosine deaminase (ADA) activity in pericardial fluid and interferon-gamma release assay positivity in both pericardial fluid and peripheral blood indicated the presence of tuberculous pericarditis. After anti-tuberculous and steroid treatment, the patient's clinical symptoms improved, and pericardial effusion has not reoccurred.

Keyword

Mycobacterium tuberculosis; Interferon-gamma release assay; Tuberculous pericarditis

MeSH Terms

Adenosine Deaminase
Diagnosis*
Interferon-gamma Release Tests*
Interferon-gamma*
Mycobacterium tuberculosis
Pericardial Effusion
Pericarditis, Tuberculous*
Adenosine Deaminase
Interferon-gamma

Figure

  • Fig. 1 Predominance of lymphocytes in pericardial effusion (Wright stain, 400×).

  • Fig. 2 T-SPOT TB results performed with cellular component of pericardial effusion. (A) Negative control (stimulated with medium alone). (B) Positive control (stimulated with phytohemagglutinin). (C) ESAT-6 (stimulated with MTB-specific peptides ESAT-6). (D) CFP-10 (stimulated with MTB-specific peptides CFP-10).


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