Recent advances in the diagnosis of intestinal tuberculosis.


Journal

BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547

Informations de publication

Date de publication:
01 Mar 2022
Historique:
received: 31 03 2021
accepted: 29 11 2021
entrez: 1 3 2022
pubmed: 2 3 2022
medline: 3 3 2022
Statut: epublish

Résumé

Intestinal tuberculosis still has a high incidence, especially in developing countries. The biggest challenge of this disease is the establishment of the diagnosis because the clinical features are not typical. Investigations such as culture, acid-fast bacilli (AFB) staining, and histopathology have low sensitivity, so other investigations are needed. Latest molecular-based diagnostic modalities such as GeneXpert, interferon-gamma (IFN-γ) release assays (IGRA), polymerase chain reaction (PCR), multiplex-PCR, and immunological markers are expected to help diagnose intestinal tuberculosis. This article review will examine the latest diagnostic modalities that can be used as a tool in establishing the diagnosis of intestinal tuberculosis. Through a literature search, we were able to review the diagnostic values of various available diagnostic modalities as the appropriate additional test in intestinal tuberculosis. Culture as a gold standard has a sensitivity and specificity value of 9.3% and 100% with the MGIT BACTEC system as the most recommended medium. The sensitivity values of AFB staining, histopathology examination, GeneXpert, IGRA, PCR, multiplex-PCR and, immunological markers were ranged between 17.3 and 31%; 68%; 81-95.7%; 74-88%; 21.6-65%; 75.7-93.1%; and 52-87%, respectively. Meanwhile the specificity values were 100%; 77.1%; 91-100%; 74-87%; 93-100%; 96.4-100%; and 70-95%, respectively. The combination of clinical examination, conventional examination, and the latest molecular-based examination is the best choice for establishing the diagnosis of intestinal tuberculosis. Most recent modalities such as multiplex PCR and immunological marker examinations are diagnostic tools that deserve to be used in diagnosing intestinal tuberculosis as their sensitivity and specificity values are quite high and more evidences are expected to support the application of these examinations shortly soon.

Sections du résumé

BACKGROUND BACKGROUND
Intestinal tuberculosis still has a high incidence, especially in developing countries. The biggest challenge of this disease is the establishment of the diagnosis because the clinical features are not typical. Investigations such as culture, acid-fast bacilli (AFB) staining, and histopathology have low sensitivity, so other investigations are needed. Latest molecular-based diagnostic modalities such as GeneXpert, interferon-gamma (IFN-γ) release assays (IGRA), polymerase chain reaction (PCR), multiplex-PCR, and immunological markers are expected to help diagnose intestinal tuberculosis. This article review will examine the latest diagnostic modalities that can be used as a tool in establishing the diagnosis of intestinal tuberculosis.
RESULTS RESULTS
Through a literature search, we were able to review the diagnostic values of various available diagnostic modalities as the appropriate additional test in intestinal tuberculosis. Culture as a gold standard has a sensitivity and specificity value of 9.3% and 100% with the MGIT BACTEC system as the most recommended medium. The sensitivity values of AFB staining, histopathology examination, GeneXpert, IGRA, PCR, multiplex-PCR and, immunological markers were ranged between 17.3 and 31%; 68%; 81-95.7%; 74-88%; 21.6-65%; 75.7-93.1%; and 52-87%, respectively. Meanwhile the specificity values were 100%; 77.1%; 91-100%; 74-87%; 93-100%; 96.4-100%; and 70-95%, respectively.
CONCLUSION CONCLUSIONS
The combination of clinical examination, conventional examination, and the latest molecular-based examination is the best choice for establishing the diagnosis of intestinal tuberculosis. Most recent modalities such as multiplex PCR and immunological marker examinations are diagnostic tools that deserve to be used in diagnosing intestinal tuberculosis as their sensitivity and specificity values are quite high and more evidences are expected to support the application of these examinations shortly soon.

Identifiants

pubmed: 35227196
doi: 10.1186/s12876-022-02171-7
pii: 10.1186/s12876-022-02171-7
pmc: PMC8885312
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

89

Subventions

Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020
Organisme : Universitas Indonesia
ID : PUTI Grant NKB-5/UN2.RST/HKP.05.00/0020

Informations de copyright

© 2022. The Author(s).

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Auteurs

Hasan Maulahela (H)

Division of Gastroenterology, Internal Medicine Department, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National Central General Hospital, Infectious Diseases and Immunology Research Center, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia. hasan.maulahela@yahoo.com.

Marcellus Simadibrata (M)

Division of Gastroenterology, Internal Medicine Department, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National Central General Hospital, Infectious Diseases and Immunology Research Center, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia.

Erni Juwita Nelwan (EJ)

Division of Tropical Medicine and Infectious Diseases, Internal Medicine Department, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Infectious Diseases and Immunology Research Center, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia.

Nur Rahadiani (N)

Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia.

Editha Renesteen (E)

Infectious Diseases and Immunology Research Center, Faculty of Medicine Universitas Indonesia, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia.

S W T Suwarti (SWT)

Infectious Diseases and Immunology Research Center, Faculty of Medicine Universitas Indonesia, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia.

Yunita Windi Anggraini (YW)

Infectious Diseases and Immunology Research Center, Faculty of Medicine Universitas Indonesia, Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia.

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