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| Content Provider | frontiers |
|---|---|
| Author | Chen, Hao Zheng, Huiwen Cui, Lang Xiao, Jing Li, Feina Wang, Yonghong Guo, Yajie Chen, Yuying Yuan, Yue Shen, Chen |
| Description | ObjectiveWe aimed to compare QuantiFERON-TB Gold In-Tube (QFT-GIT) and X.DOT-TB for screening latent tuberculosis infection (LTBI) in kawasaki patients, and to identify the risk factors associated with indeterminate IGRA results.MethodsWe conducted a retrospective study on children with KD, who were screened for mycobacterium tuberculosis (Mtb) infection by either ELISA-based QFT-GIT or ELISPOT-based X.DOT-TB tests, admitted in Department of Cardiology, Beijing Children's Hospital from July 2019 to April 2022.ResultsA total of 1327 cases were included. Among them, 932 cases were tested by QFT-GIT and 395 cases by X.DOT-TB. The positive rate of children was 0.1% and 0.2%, and the indeterminate rate was 68.2% and 6.1% for QFT-GIT and X.DOT-TB, respectively. Patients with hypoproteinemia had a higher risk of indeterminate X.DOT-TB result. Female, critical ill, shock or hypoproteinemia presented statistically significant associations with an increased risk of indeterminate QFT-GIT result. High-dose of IVIG inhibited the release of IFN-γ by more than 90%, which might account for the high indeterminate incidence.ConclusionIt is recommended to perform X.DOT-TB rather than QFT-GIT to screen LTBI in patients with high level of the mitogen that can inhibit IFN-γ release. For KD children with positive IGRA results, it has a higher risk of activation TB infection when treated with immunosuppressive therapy in the future. Children with KD aged <5 years old had higher frequency of indet... |
| Abstract | Kawasaki disease (KD) is an acute systemic vasculitis of young children with unknown etiology. Identify mycobacterium tuberculosis (Mtb) infected KD patients by interferon-gamma release assays (IGRAs) before immunosuppressive therapy with glucocorticoids, tumour necrosis factor (TNF)-alpha inhibitors, and others were highly recommended , as these therapy would increase the risk of active tuberculosis (TB) disease in latently Mtb infected individuals. Here we evaluated the performance of the two common used by interferon-gamma release assays (IGRAs), ELISA-based QFT-GIT and ELISPOT-based X.DOT-TB tests, for identification of Mtb infection in KD children, and analyzed the associate factors effecting the test results by conducing a retrospective study on children with KD who were screened for Mtb infection by either two IGRAs at admission and hospitalized in Beijing Children's Hospital from July 2019 to April 2022. A total of 1327 cases were included. Among them, 932 cases were tested by QFT-GIT and 395 cases by X.DOT-TB. The positive rate of children was 0.1% and 0.2% by QFT-GIT and X.DOT-TB respectively, and the indeterminate rate was 68.2% and 6.1%. Patients with hypoproteinemia had a higher risk of getting an indeterminate X.DOT-TB result, and female, with critical ill, shock or hypoproteinemia presented statistically significant associations with an increased risk of obtaining an indeterminate QFT-GIT result. IVIG, as one commonly used key first-line KD therapeutic drug, could inhibited mitogen stimulated IFN-γ release directly with a high-dose inhibition by more than 90%, that might account for the high indeterminate incidence. In conclusion, X.DOT-TB could be more suitable than QFT-GIT for Mtb infection screening in children with KD. |
| ISSN | 22962360 |
| DOI | 10.3389/fped.2023.1162547 |
| Volume Number | 11 |
| Journal | Frontiers in Pediatrics |
| Language | English |
| Publisher Date | 2023-05-18 |
| Access Restriction | Open |
| Subject Keyword | Interferon-gamma release assays Kawasaki disease Tuberculosis Children Immunosuppressive therapy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health |
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