Value of Gamma Interferon Enzyme-linked Immunospot Assay in the Diagnosis of Peritoneal Dialysis-associated Tuberculous Peritonitis

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2021 Jul 15

PMID 34263436

Citations 3

Authors

Qiuxia Fan

Xiaoyan Huang

Jieyun Zhang

Yinan Sun

Zuying Xiong

Zibo Xiong

Affiliations

Soon will be listed here.

Abstract

Background: Tuberculous peritonitis is the most common form of extrapulmonary tuberculosis infection in peritoneal dialysis patients. However, diagnosing tuberculous peritonitis quickly and early has always been a challenge for nephrologists. Mycobacterium tuberculosis antigen-specific gamma interferon enzyme-linked immunospot (IFN-γ ELISPOT) assay has been widely used in the clinical diagnosis of tuberculous pleurisy and peritonitis, but its use has not been reported for uremia.

Methods: This study mainly verified the feasibility of using the M. tuberculosis antigen-specific IFN-γ ELISPOT assay in the diagnosis of continuous ambulatory peritoneal dialysis (CAPD) patients with tuberculous peritonitis. Taking M. tuberculosis culture as the gold standard, the IFN-γ ELISPOT assay was used to analyze peripheral blood and peritoneal dialysis fluid of patients, and the receiver operating characteristic (ROC) curves in patients with tuberculous peritonitis (TBP) or non-tuberculous peritonitis (NTBP) were analyzed.

Results: The area under the receiver operating characteristic curve (AUC) was 0.927 (95% CI 0.816-1.000, P = 0.001) for the ELISPOT assay with peritoneal fluid mononuclear cells (PFMC), which was higher than that for the ELISPOT assay with peripheral blood mononuclear cells (PBMC) (0.825, 95% CI 0.6490-1.000, P = 0.011). The cutoff value for the diagnosis of TBP was 40 spot-forming cells (SFCs)/2 × 10 for the ELISPOT with PBMC, with a sensitivity of 55.6%, a specificity of 92.3%, and a diagnostic efficiency of 77.3%. The cutoff value for the diagnosis of TBP was 100 SFCs/2 × 10 for the ELISPOT on PFMC, with a sensitivity, specificity, and diagnostic efficiency 77.8%, 84.6%, and 81.8%, respectively. Parallel and serial testing algorithms appeared more accurate than single ELISPOT assays with PBMC, but ELISPOT assays with PFMC.

Conclusions: The IFN-γ release test can be used for the early diagnosis of CAPD-related TBP; compared with peripheral blood, peritoneal fluid may be a more effective and accurate medium to diagnose CAPD complicated with tuberculous peritonitis.

Citing Articles

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Fasquelle F, Vreulx A, Betbeder D PLoS One. 2024; 19(5):e0301687.

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Early diagnosis of tuberculous peritonitis in peritoneal dialysis patients using the T-SPOT test.

Okubo N, Suwabe T, Yamanouchi M, Ikuma D, Mizuno H, Oba Y CEN Case Rep. 2024; 13(6):499-503.

PMID: 38643328 PMC: 11608194. DOI: 10.1007/s13730-024-00882-2.

Evolution of Peritoneal Dialysis-Associated Peritonitis: Pathogen, Antibiotic Resistance, and the Impact of Lymphocyte Count on Treatment Outcomes.

He Y, Yang G, Wang P, Wang X, Xiong Z, He Y Infect Drug Resist. 2024; 17:685-696.

PMID: 38405055 PMC: 10887942. DOI: 10.2147/IDR.S442641.

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