• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.519-528
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• 2009

결핵은 아직도 전세계적으로 소아에서 높은 유병률과 사망률을 보이는 질환이다. 아쉽게도 결핵에 대한 새로운 진단법, 치료법, 예방법에 대한 과학적 혹은 임상 연구는 주로 성인에 초점을 맞추어 왔으며 소아 결핵은 상대적으로 등한시되어 왔다. 그러나 특히 소아 결핵은 감염 후 중한 질환으로 진행되기 쉬우며 이는 사망을 초래하기도 한다. 또한 소아청소년기의 잠복결핵 감염은 후일 결핵균의 재활성으로 인하여 미래의 감염원으로 작용한다. 따라서 미래의 결핵 발생을 줄이기 위해서는 잠복결핵 감염에 대한 특징, 진단, 치료에 대해 이해하는 것이 매우 중요한다. 그러나 우리나라의 국가 결핵관리정책에는 이러한 개념들이 완전히 적용되지 않았으므로, 가능한 빨리 포함되고 시행되어져야 한다.

• Tuberculosis and Respiratory Diseases
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• 제73권4호
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• pp.234-238
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• 2012

Recently, interferon gamma releasing assay has been recommended to compensate the tuberculin skin test (TST) for screening for latent tuberculosis infection (LTBI). Although it improved the detection of LTBI before treatment with tumor necrosis factor blocker, its application to immune suppressed patients is limited. We report a case of peritoneal tuberculosis (TB) developed in a patient who tested positive for TST and QuantiFERON-TB Gold (QFT-G) before infliximab therapy, to emphasize the importance of monitoring during treatment. A 52-year-old woman presented with abdominal distension. She had been diagnosed with seropositive rheumatoid arthritis six years ago. She had started taking infliximab six months ago. All screening tests for TB were performed and the results of all were negative. At admission, the results of repeated TST and QFT-G tests were positive. Histopathological examination confirmed peritoneal TB. The patient started anti-TB therapy and the symptoms were relieved.

• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.125-131
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• 2011

Background: The clinical manifestation of $M.$ $tuberculosis$ infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-${\gamma}$ release assay according to the wide spectrum of clinical phenotypes. Methods: In patients diagnosed with active TB that underwent $QuantiFERON^{(R)}$ (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. Results: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). Conclusion: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.