Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/92607
標題: 新喋呤對偵測結核感染的診斷價值-類風溼性關節炎患者接受生物製劑治療期間發生QFT結果轉變
Diagnostic value of neopterin for detecting tuberculosis in rheumatoid arthritis patients with QuantiFERON conversion during biologic therapy
作者: 葉雅雯
Yea-Wen Yeh
關鍵字: 新喋呤;結核感染;生物製劑;類風濕性關節炎;結核菌感染診斷試管組;neopterin;tuberculosis (TB);biologics;rheumatoid arthritis (RA);QuantiFERON-TB-Gold In Tube (QFT-GIT)
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摘要: 
Frequent QuantiFERON-TB-Gold In Tube (QFT-GIT) conversion was observed in rheumatoid arthritis (RA) patients receiving biologic therapy. We aimed to evaluate the diagnostic utility of plasma cytokines and chemokines for identifying active tuberculosis (TB) in RA patients with QFT conversion.
We prospectively evaluated 187 patients who received biologic therapy and serial QFT-GIT assays. QFT-GIT was performed by measuring IFN-γ levels in whole blood treated with TB-specific antigens. Levels of TB-related cytokines and chemokines at the time of QFT-GIT assays were determined by multiplex assay using the Milliplex MAP Human Cytokine/ Chemokine Panel and enzyme-linked immunosorbent assay.
QFT conversion was observed in 54 (28.9%) of 187 RA patients, 54 RA patients with QFT conversion at baseline, 7 patients developed active TB (RA-TB) during the period of biologic therapy. Neopterin levels assessed at the time of active TB were higher in RA-TB patients than in RA non-TB subjects. The optimal cut-off neopterin level for detecting active TB using ROC curve analysis was 5045 pg/ml.
RA patients with QFT conversion during the period of biologic therapy should be carefully evaluated and stimulated levels (TB-specific antigens) of neopterin may provide an useful information for identifying active TB.
URI: http://hdl.handle.net/11455/92607
其他識別: U0005-1708201512373600
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