■我们旨在比较QuantiFERON-TB金管(QFT-GIT)和X.DOT-TB在川崎患者中筛查潜伏性结核感染(LTBI),并确定与不确定的IGRA结果相关的危险因素。
■我们对KD儿童进行了回顾性研究,通过基于ELISA的QFT-GIT或基于ELISPOT的X.DOT-TB测试筛查结核分枝杆菌(Mtb)感染,入住心脏病学,北京儿童医院,2019年7月至2022年4月。
■共纳入1327例。其中,QFT-GIT检测932例,X.DOT-TB检测395例。患儿的阳性率分别为0.1%和0.2%,QFT-GIT和X.DOT-TB的不确定率为68.2%和6.1%,分别。低蛋白血症患者出现X.DOT-TB结果不确定的风险较高。女性,病危,休克或低蛋白血症与不确定的QFT-GIT结果的风险增加具有统计学意义.高剂量的IVIG抑制IFN-γ的释放超过90%,这可能是不确定发生率高的原因。
■建议在能够抑制IFN-γ释放的丝裂原水平较高的患者中进行X.DOT-TB而不是QFT-GIT筛查LTBI。对于IGRA结果为阳性的KD儿童,将来用免疫抑制疗法治疗时,它有更高的激活结核感染风险。年龄<5岁的KD儿童出现不确定IGRA结果的频率更高。
UNASSIGNED: We 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.
UNASSIGNED: We 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.
UNASSIGNED: 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%, 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.
UNASSIGNED: It 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 indeterminate IGRA results.