ArticleInternational journal of hematology2014
An indeterminate result of QuantiFERON-TB Gold In-Tube for miliary tuberculosis due to a high level of IFN-γ production.
Article in International journal of hematology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Sensitivity of Immunodiagnostic Tests in Localized Versus Disseminated Tuberculosis-A Systematic Review of Individual Patient Data.Tropical medicine and infectious disease · 2025Review
- Article
- Features of indeterminate results of QuantiFERON-TB Gold In-Tube test in patients with haematological malignancies.Therapeutic advances in hematology · 2021Article
- Alternative Quantiferon cytokines for diagnosis of children with active tuberculosis and HIV co-infection in Ghana.Medical microbiology and immunology · 2017Article
- IFN-γ Release Assay Result Is Associated with Disease Site and Death in Active Tuberculosis.Annals of the American Thoracic Society · 2016Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
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Abstract
The QuantiFERON-TB Gold In-Tube(®) test has excellent specificity for Mycobacterium tuberculosis. However, diagnosis of miliary tuberculosis remains challenging, and the interpretation of QuantiFERON(®) results in immunocompromised individuals has not been fully established. Here, we present a patient with military tuberculosis who showed an indeterminate QuantiFERON(®) result. A 76-year-old male presented with fever and pancytopenia. Radiological tests did not show the classical miliary pattern. Acid-fast staining and polymerase chain reaction of several specimens were negative for M. tuberculosis. The QuantiFERON(®) responses were indeterminate on two separate tests, as interferon-γ (IFN-γ) concentration was high in the negative control. The patient did not respond to anti-microbiological therapy, and developed sepsis and disseminated intravascular coagulation, leading to lethal intracranial hemorrhage. An autopsy showed miliary tuberculosis and aplastic anemia. A literature review suggests a tendency towards indeterminate or false-negative QuantiFERON(®) results in immunocompromised individuals or patients with miliary tuberculosis due to low production of IFN-γ. Our patient, however, showed substantial amounts of IFN-γ despite lymphocytopenia, which has not been reported in the literature. The present case suggests that indeterminate results of QuantiFERON(®) should be interpreted with caution, as IFN-γ production in patients with miliary tuberculosis can vary significantly, even with sustained lymphocytopenia.
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