Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China
Background: Atypical spinal tuberculosis (TB) usually presents in a slowly indolent manner with nonspecific clinical presentations making the diagnosis a great challenge for physicians. New technologies for the detection of atypical spinal TB are urgently needed. The aim of this study was to assess...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2013-09-01
|
| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867013001414 |
| _version_ | 1819050136087560192 |
|---|---|
| author | Kai Yuan Zhao-ming Zhong Qiang Zhang Shu-chai Xu Jian-ting Chen |
| author_facet | Kai Yuan Zhao-ming Zhong Qiang Zhang Shu-chai Xu Jian-ting Chen |
| author_sort | Kai Yuan |
| collection | DOAJ |
| description | Background: Atypical spinal tuberculosis (TB) usually presents in a slowly indolent manner with nonspecific clinical presentations making the diagnosis a great challenge for physicians. New technologies for the detection of atypical spinal TB are urgently needed. The aim of this study was to assess the diagnostic value of an enzyme-linked immunospot (ELISPOT) assay in clinically suspected cases of atypical spinal TB in China. Methods: From March 2011 to September 2012, a total of 65 patients with suspected atypical spinal TB were enrolled. In addition to conventional tests for TB, we used ELISPOT assays to measure the IFN-γ response to ESAT-6 and CFP-10 in T-cells in samples of peripheral blood mononuclear cells. Patients with suspected atypical spinal TB were classified by diagnostic category. Data on clinical characteristics of the patients and conventional laboratory results were collected. Results: Out of 65 patients, 4 were excluded from the study. 18 (29.5%) subjects had culture-confirmed TB, 11 (18.0%) subjects had probable TB, and the remaining 32 (52.5%) subjects did not have TB. Generally, the features of atypical spinal TB include the following aspects: (1) worm-eaten destruction of vertebral endplate; (2) destruction of centricity of the vertebral body or concentric collapse of vertebral body; (3) tuberculous abscess with no identifiable osseous lesion; (4) contiguous or skipped vertebral body destruction. 26 patients with atypical spinal TB had available biopsy or surgical specimens for histopathologic examination and 23 (88.5%) specimens had pathologic features consistent with TB infection. The sensitivities of the PPD skin test and ELISPOT assay for atypical spinal TB were 58.6% and 82.8%, and their specificities were 59.4% and 81.3%, respectively. Malnutrition and age were associated with ELISPOT positivity in atypical spinal TB patients. Conclusions: The ELISPOT assay is a useful adjunct to current tests for diagnosis of atypical spinal TB. Keywords: Atypical spinal tuberculosis, Enzyme-linked immunospot assay, T-SPOT.TB kit, Diagnosis |
| first_indexed | 2024-12-21T11:43:15Z |
| format | Article |
| id | doaj.art-2f238654256943d7a143ad325461e538 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-21T11:43:15Z |
| publishDate | 2013-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-2f238654256943d7a143ad325461e5382022-12-21T19:05:14ZengElsevierBrazilian Journal of Infectious Diseases1413-86702013-09-01175529537Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in ChinaKai Yuan0Zhao-ming Zhong1Qiang Zhang2Shu-chai Xu3Jian-ting Chen4Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, ChinaDepartment of Orthopedics, Guangzhou Thoracic Hospital, ChinaDepartment of Orthopaedices, The Second Affiliated Hospital of Guangzhou Traditional Chinese Medicine University, ChinaDepartment of Spinal Surgery, Nanfang Hospital, Southern Medical University, China; Corresponding author at: Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.Background: Atypical spinal tuberculosis (TB) usually presents in a slowly indolent manner with nonspecific clinical presentations making the diagnosis a great challenge for physicians. New technologies for the detection of atypical spinal TB are urgently needed. The aim of this study was to assess the diagnostic value of an enzyme-linked immunospot (ELISPOT) assay in clinically suspected cases of atypical spinal TB in China. Methods: From March 2011 to September 2012, a total of 65 patients with suspected atypical spinal TB were enrolled. In addition to conventional tests for TB, we used ELISPOT assays to measure the IFN-γ response to ESAT-6 and CFP-10 in T-cells in samples of peripheral blood mononuclear cells. Patients with suspected atypical spinal TB were classified by diagnostic category. Data on clinical characteristics of the patients and conventional laboratory results were collected. Results: Out of 65 patients, 4 were excluded from the study. 18 (29.5%) subjects had culture-confirmed TB, 11 (18.0%) subjects had probable TB, and the remaining 32 (52.5%) subjects did not have TB. Generally, the features of atypical spinal TB include the following aspects: (1) worm-eaten destruction of vertebral endplate; (2) destruction of centricity of the vertebral body or concentric collapse of vertebral body; (3) tuberculous abscess with no identifiable osseous lesion; (4) contiguous or skipped vertebral body destruction. 26 patients with atypical spinal TB had available biopsy or surgical specimens for histopathologic examination and 23 (88.5%) specimens had pathologic features consistent with TB infection. The sensitivities of the PPD skin test and ELISPOT assay for atypical spinal TB were 58.6% and 82.8%, and their specificities were 59.4% and 81.3%, respectively. Malnutrition and age were associated with ELISPOT positivity in atypical spinal TB patients. Conclusions: The ELISPOT assay is a useful adjunct to current tests for diagnosis of atypical spinal TB. Keywords: Atypical spinal tuberculosis, Enzyme-linked immunospot assay, T-SPOT.TB kit, Diagnosishttp://www.sciencedirect.com/science/article/pii/S1413867013001414 |
| spellingShingle | Kai Yuan Zhao-ming Zhong Qiang Zhang Shu-chai Xu Jian-ting Chen Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China Brazilian Journal of Infectious Diseases |
| title | Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China |
| title_full | Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China |
| title_fullStr | Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China |
| title_full_unstemmed | Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China |
| title_short | Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China |
| title_sort | evaluation of an enzyme linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis atypical clinical presentation atypical radiographic presentation in china |
| url | http://www.sciencedirect.com/science/article/pii/S1413867013001414 |
| work_keys_str_mv | AT kaiyuan evaluationofanenzymelinkedimmunospotassayfortheimmunodiagnosisofatypicalspinaltuberculosisatypicalclinicalpresentationatypicalradiographicpresentationinchina AT zhaomingzhong evaluationofanenzymelinkedimmunospotassayfortheimmunodiagnosisofatypicalspinaltuberculosisatypicalclinicalpresentationatypicalradiographicpresentationinchina AT qiangzhang evaluationofanenzymelinkedimmunospotassayfortheimmunodiagnosisofatypicalspinaltuberculosisatypicalclinicalpresentationatypicalradiographicpresentationinchina AT shuchaixu evaluationofanenzymelinkedimmunospotassayfortheimmunodiagnosisofatypicalspinaltuberculosisatypicalclinicalpresentationatypicalradiographicpresentationinchina AT jiantingchen evaluationofanenzymelinkedimmunospotassayfortheimmunodiagnosisofatypicalspinaltuberculosisatypicalclinicalpresentationatypicalradiographicpresentationinchina |