TUBERCULIN SKIN TEST AND INTERFERON-γ RELEASE ASSAY ON THE DIAGNOSIS OF TUBERCULOUS SPONDYLITIS
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Highlights
- TST and IGRA have a significant correlation with the diagnosis of patients with Tuberculous Spondylitis.
- Various factors may affect the results of TST and IGRA. Thus, the use of TST and IGRA can be adjusted according to the condition of the hospital, the availability of diagnostic tools, the health worker's physical examination results, and the patient's medical history.
Abstract
Background: Tuberculous spondylitis or Pott's disease is extrapulmonary tuberculosis that is still a concern to health workers because of the broad spectrum of its clinical symptoms. Delay in diagnosis is very common in this disease. Therefore, its diagnostic tool needs to be thoroughly reviewed to determine its effectiveness. The diagnostic tools studied in this study were Tuberculin Skin Test (TST) and Interferon-γ Release Assay (IGRA). Objective: To analyze the role of TST and IGRA as diagnostic tools for the diagnosis of tuberculous spondylitis. Material and Method: This study used a systematic review method to analyze topic-related kinds of literature written in English and Indonesian found on PubMed, Scopus, ProQuest, and Web of Science databases. The literature screening process was carried out based on the PRISMA 2020 Guidelines. Result: Sixteen types of literature were included for a total of 116 patients. TST was detected positive in 45 (63%) and negative in 21 (30%) of a total of 66 patients with Pott's disease. IGRA was detected positive in 51 (77%), negative in 8 (12%), and indeterminate in 2 (3%) of a total of 61 patients with Pott's disease. Conclusion: TST and IGRA results significantly correlate with the diagnosis of tuberculous spondylitis. Both tests are still relevant for use in the diagnosis of the disease. IGRA and TST are used according to the needs of health workers and patients' health backgrounds.
Ansari, S., Amanullah, M.F., Rauniyar, R., Ahmad, K. 2013. Pott"²s spine: Diagnostic imaging modalities and technology advancements. North American Journal of Medical Sciences, 5(7): 404. doi: 10.4103/1947-2714.115775.
Batirel, A., Erdem, H., Sengoz, G., Pehlivanoglu, F., Ramosaco, E., et al. 2015. The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study. Clinical Microbiology and Infection, 21(11): 1008.e9-1008.e18. doi: 10.1016/j.cmi.2015.07.013.
Centers for Disease Control and Prevention (CDC). 2020. Tuberculin skin testing fact sheet, CDC. Available at: https://www.cdc.gov/tb/publications/factsheets/testing/skintesting.htm (Accessed: 20 July 2022).
Chen, C.H., Chen, Y.M., Lee, C.W., Chang, Y.J., Cheng, C.Y., et al. 2016. Early diagnosis of spinal tuberculosis. Journal of the Formosan Medical Association, 115(10): 825–836. doi: 10.1016/j.jfma.2016.07.001.
Colmenero, J.D., Mesa, J.D.R., Jimenez, R.S., Sobrino, B., Morata, P. 2013. Establishing the diagnosis of tuberculous vertebral osteomyelitis. European Spine Journal, 22(S4): 579–586. doi: 10.1007/s00586-012-2348-2.
Dean, A., Zyck, S., Toshkezi, G., Galgano, M., Marawar, S. 2019. Challenges in the diagnosis and management of spinal tuberculosis: Case series. Cureus. doi: 10.7759/cureus.3855.
Goletti, D., Delogu, G., Matteelli, A., Migliori, G.B. 2022. The role of IGRA in the diagnosis of tuberculosis infection, differentiating from active tuberculosis, and decision making for initiating treatment or preventive therapy of tuberculosis infection. International Journal of Infectious Diseases, 124: S12–S19. doi: 10.1016/j.ijid.2022.02.047.
Kumar, M., Kumar, R., Srivastava, A. K., Nag, V. L., Maurya, A. K., et al. 2013. Clinical utility of interferon- γ releases assays (IGRAS) in pott's disease. International Journal of Bioassays, 2(4): 655-660. Available at: https://www.ijbio.com/articles/clinical-utility-of-interferon-releases-assay-igras-in-potts-disease.pdf.
Kumar, R., Das, R.K., Mahapatra, A. K. 2010. Role of interferon γ release assay in the diagnosis of Pott disease. Journal of Neurosurgery: Spine, 12(5): 462–466. doi: 10.3171/2009.10.SPINE093.
Kusmiati, T., Narendrani, H. P. 2019. POTT'S disease. Jurnal Respirasi, 2(3): 99. doi: 10.20473/jr.v2-I.3.2016.99-109.
Ma, Y., Xu, Y., Cao, X., Chen, X., Zhong, Y. 2021. Diagnostic value of interferon- γ release assay in HIV-infected individuals complicated with active tuberculosis: a systematic review and meta-analysis. Epidemiology and Infection, 149: e204. doi: 10.1017/S0950268821001953.
Merino, P., Candel, F.J., Gestoso, I., Baos, E., Picazo, J. 2012. Microbiological diagnosis of spinal tuberculosis. International Orthopaedics, 36(2): 233–238. doi: 10.1007/s00264-011-1461-x.
Minakata, T., Nakano, Y., Tamura, S., Kazuki, Y., Hayakawa, K., et al. 2020. Tuberculous spondylitis caused by intravesical bacillus calmette-guerin therapy. Internal Medicine, 59(5): 733–737. doi: 10.2169/internalmedicine.3288-19.
Moon, M.-S. 2014. Tuberculosis of spine: Current views in diagnosis and management. Asian Spine Journal, 8(1): 97. doi: 10.4184/asj.2014.8.1.97.
Prijambodo, B., Pratama, U. S. 2020. Clinical, laboratory and radiologic evaluations in patients with malignant tuberculous spondylitis. Indian Journal of Forensic Medicine and Toxicology, 14(4), 4476-4481. https://doi.org/10.37506/ijfmt.v14i4.12346.
Rajasekaran, S., Soundararajan, D.C.R., Shetty, A.P., Kanna, R.M. 2018. Spinal tuberculosis: Current concepts. Global Spine Journal, 8(4_suppl): 96S-108S. doi: 10.1177/2192568218769053.
Rasouli, M.R., Mirkoohi, M., Vaccaro, A.R., Yarandi, K,K., Movaghar, V.R. 2012. Spinal tuberculosis: Diagnosis and management. Asian Spine Journal, 6(4): 294. doi: 10.4184/asj.2012.6.4.294.
Senanayake, M. P., Karunaratne, I. 2014. A child presenting with tuberculous spondylitis in a single third cervical vertebra: a case report. Journal of Medical Case Reports, 8(1): 284. doi: 10.1186/1752-1947-8-284.
Tebruegge, M., de Graaf, H., Sukhtankar, P., Elkington, P, Marshall, B., et al. 2014. Extremes of age are associated with indeterminate quantiFERON-TB gold assay results. Journal of Clinical Microbiology. Edited by G. A. Land, 52(7): 2694–2697. doi: 10.1128/JCM.00814-14.
World Health Organization. 2023. Tuberculosis, WHO. Available at: https://www.who.int/news-room/fact-sheets/detail/tuberculosis.
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