Lino A, Lalande V, Guetta A, Lebeau B, Heron E, Chouaid C
Service de pneumologie, hôpital Saint-Antoine, 184 rue du Faubourg-Saint-Antoine, Paris cedex 12, France.
Rev Mal Respir. 2011 Mar;28(3):317-21. doi: 10.1016/j.rmr.2011.02.004. Epub 2011 Mar 10.
M. tuberculosis is a possible cause of uveitis; the diagnosis is often difficult. The aim of this study is to evaluate, in this context, the application of an interferon gamma assay, the SpotTB™. The prospective study, in patients presenting with uveitis without obvious cause and not resolving with local treatment, compared the therapeutic approach (giving antituberculous treatment or not) with and without the result of the SpotTB™. The analyses included 23 patients: 78% had received BCG; 78% had isolated ocular involvement; 22% had associated mediastinal lymphadenopathy. The results of the IDR and the SpotTB™ were concordant in 61%, discordant in 22% and non-evaluable in 17% of cases. In the patients with isolated ocular involvement the SpotTB™ avoided treatment in five and reinforced the decision not to treat in 13 others. In the patients with mediastinal lymphadenopathy, the SpotTB™ reinforced the diagnosis of sarcoidosis in four cases (one lost from view). In conclusion, when infection with M. tuberculosis is considered in the aetiology of uveitis the SpotTB™ allows, in a significant number of cases, the avoidance of antituberculous treatment.
结核分枝杆菌是葡萄膜炎的一个可能病因；诊断往往很困难。本研究的目的是在此背景下评估一种干扰素γ检测方法——SpotTB™的应用。这项前瞻性研究针对无明显病因且局部治疗无效的葡萄膜炎患者，比较了有和没有SpotTB™检测结果时的治疗方法（是否给予抗结核治疗）。分析纳入了23例患者：78%接种过卡介苗；78%为单纯眼部受累；22%伴有纵隔淋巴结肿大。在61%的病例中，IDR和SpotTB™的结果一致，22%不一致，17%无法评估。在单纯眼部受累的患者中，SpotTB™使5例避免了治疗，并使另外13例强化了不进行治疗的决定。在伴有纵隔淋巴结肿大的患者中，SpotTB™在4例中强化了结节病的诊断（1例失访）。总之，当在葡萄膜炎病因中考虑结核分枝杆菌感染时，SpotTB™在相当多的病例中可避免抗结核治疗。
