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Place of neopterin level in the differential diagnosis of tuberculosis pleurisy

Year 2013, Volume: 2 Issue: 2, 65 - 70, 08.09.2013

Faysal Duksal İsa Döngel Fatma Duksal Armağan Hazar

https://doi.org/10.12808/bcs.v2i2.27

Abstract

Absract

Aim. Tuberculous pleurisy, a form of tuberculosis, may be confused with many other diseases.  This study was designed to assess the diagnostic value of pleural fluid neopterin levels in tuberculous pleurisy. Methods. Total 57 patients (30 patients with tuberculosis pleurisy, 17 cases with malignant pleural effusion, 10 cases of pleural effusion due to congestive heart failure) were studied. The measurement of neopterin levels was conducted by the enzymeimmunassay method and Trinity-Biotech XL fully automatic ELISA kit device and neopterin IBL kit. Results. The neopterin levels in pleural fluid due to tuberculosis were significantly higher than that of both malignancy and congestive heart failure (p<0.001). The neopterin levels of patients with congestive heart failure and malignancy were found as similar (p=0.920). There was no significant difference in the neopterin levels with regard to age and sex (p>0.05). Conclusions. Tuberculous pleurisy increases neopterin levels of pleural fluid as compared with pleural fluid related to malignancy and congestive heart failure. It is thought that neopterin level in the pleural fluid may be used in the diagnosis of  tuberculosis.

Keywords: Neopterin, pleural effusion, tuberculous pleurisy

Özet

Amaç. Tüberkülozun bir tipi olan tüberküloz plörezi birçok hastalık ile karıştırılabilir. Bu çalışma tüberküloz plörezide plevral sıvıda neopterin düzeylerini değerlendirmek amacı ile oluşturulmuştur. Yöntem. Toplam 57 hasta (30 tüberküloz plörezi, 17 malign plevral efüzyon ve 10 konjestif kalp yetmezliği olgusu) çalışmaya alındı. Neopterin düzeylerinin ölçümü enzimimmünoassay yöntemi ve Trinity-Biotech XL tam otomatik ELISA kit aleti ve neopterin IBL kiti ile gerçekleştirildi. Bulgular. Tüberküloza bağlı oluşan plevral sıvıdaki neopterin düzeyi malignite ve konjestif kalp yetmezliğine bağlı olanlarınkine göre anlamlı derecede yüksek bulundu (p<0,001). Konjestif kalp yetmezliği ve maligniteye bağlı plevral sıvıların neopterin düzeyleri benzer bulundu (p=0,920). Yaş ve cinsiyete göre neopterin düzeylerinde anlamlı değişiklik bulunmadı (p>0,05). Sonuçlar. Tüberküloz plörezi malignite ve konjestif kalp yetmezliğine bağlı plevral sıvılara göre daha fazla neopterin düzeyine sahiptir. Plevral sıvıda neopterin ölçümünün tüberküloz tanısında kullanılması olasıdır.

Anahtar sözcükler: Neopterin, plevral efüzyon, tüberküloz plörezi

Keywords

Neopterin; pleural effusion; tuberculous pleurisy

References

  • Lin C-M, Lin S-M, Chung F-T, Lin H-C, Lee K-Y, et al. Amplified Mycobacterium Tuberculosis Direct Test for Diagnosing Tuberculous Pleurisy. A Diagnostic Accuracy Study. PLoS ONE 2012; 7(9): e44842. doi:10.1371/journal. pone.0044842
  • Huber C, Batchelor JR, Fuchs D, Hausen A, Lang A, Niederwieser D, et al. Immune response-associated production of neopterin. Release from macrophages primarily under control of interferon-gamma. J Exp Med. 1984 Jul 1;160(1):310-6.
  • Valdes L, Pose A, San Jose E, Marti nez Vazquez JM. Tuberculous pleural effusions. Eur J Intern Med 2003; 14: 77–88.
  • Liam CK, Lim KH, Wong CM. Causes of pleural exudates in a region with a high incidence of tuberculosis. Respirology 2000;5: 33–38.
  • Tanrıkulu AÇ, Abakay A, Abakay Ö, Alp A. Diyarbakır ilinde tüberküloz insidansını etkileyen faktörler. Tüberküloz ve Toraks Dergisi 2007; 55(1): 18-23
  • Bahar B, Demir R, Özesmi M. Kayseri Nuh Naci Yazgan Göğüs Hastalıkları Hastanesi’nde yatan son 8 yıllık vakaların analizi. Tüberküloz ve Toraks 1989;37:59
  • Greco S, Rulli M, Girardi E, Piersimoni C, Saltini C. Diagnostic accuracy of in-house PCR for pulmonary tuberculosis in smear-positive patients: meta-analysis and metaregression. J Clin Microbiol 2009; 47:569-76.
  • Karalezli A, Gündoğdu C, Samurkaşoğlu B, Dursun G, Bener B, Uğur P. Tüberküloz plörezi tanısında gamma interferonun rolü “Adenozin deaminaz ile karşılaştırılması”. Solunum Hastalıkları. 1994; 5: 233-41.
  • Wongtim S, Silachamroon U, Ruxrungtham K, Udompanich V, Limthongkul S, Charoenlap P et al. Interferon gamma for diagnosing tuberculous pleural effusion. Thorax 1999; 54: 921-4.
  • Light R W, MacGregor M I, Luchsinger P C, Ball W C. Pleural effusions: The diagnostic seperation of transudates and exudates. Ann Intern Med 1972;77:507-13.
  • Chakko S C, Caldwell S H, Sforza P P. Treatment of conjestive heart failure: its effect on pleural fluid chemistry. Chest 1989;95:978-82.
  • Shinto RA, Light RW. The effects of diüresis upon the characteristics of pleural fluid in patients with congestive heart failure. Am Rev Respir Dis 1988;137:458.
  • Romero-Candeira S, Fernández C, Martín C, Sánchez-Paya J, Hernández L. Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure. Am J Med 2001;110:681-6.
  • Huber C, Batchelor JR, Fuchs D, Hausen A, Lang A, Niederwieser D, et al. Immune response – associated production of neopterin: relase of macrophages primarily under the control of interferongamma. J Exp. Med 1984; 160: 310 – 16.
  • Werner ER, Bichler A, Daxenbichler G, Fuchs D, Fuith LC, Hausen A, et al. Determination of neopterin in serum and urine. Clin Chem 1987; 33: 62–66.
  • Cok G, Parıldar Z, Basol G, Kabaroglu C, Bayindir U, Habif S, et al. Pleural fluid neopterin levels in tuberculous pleurisy. Clin Biochem. 2007 Aug;40(12):876-80.
  • Yadav AK, Sharma V, Jha V. Association between serum neopterin and inflammatory activation in chronic kidney disease. Mediators Inflamm. 2012; Article ID 476979, 6 pages doi: 10.1155/2012/476979.
  • Lhee HY, Kim H, Joo KJ, Jung SS, Lee KB. The clinical significance of serum and urinary neopterin levels in several renal diseases. J Korean Med Sci. 2006;21(4):678
  • Baganha MF, Mota-Pinto A, Pêgo MA, Marques MA, Rosa MA, Cordeiro AJ. Neopterin in tuberculous and neoplastic pleural fluids. Lung 1992;170:155-161.
  • Immanuel C, Swamy R, Kannapiran M, Vijayalakshmi S, Sundaram V, Jagannath K,. et al. Neopterin as a marker for cell-mediated immunity in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis. 1997 Apr;1:175-80.

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Year 2013, Volume: 2 Issue: 2, 65 - 70, 08.09.2013

Faysal Duksal İsa Döngel Fatma Duksal Armağan Hazar

https://doi.org/10.12808/bcs.v2i2.27

Abstract

Amaç. Tüberküloz plörezi akciğer tüberkülozunun en sık formlarından biri olup birçok hastalıkla karışabilir. Bu çalışma tüberküloz plörezili hastaların plevral sıvılarındaki neopterin seviyelerinin tanısal değerini belirlemek için yapılmıştır. Yöntem. Toplam 57 hasta [tüberküloz plörezi (n=30), malign plevral efüzyon (n=17) ve konjestif kalp yetmezliği Corresponding Author: Dr. İsa Döngel, Göğüs Cerrahisi AD, Süleyman Demirel Üniversitesi Tıp Fakültesi, Isparta. Email: drdongel@hotmail.com (n=10)] çalışmaya alındı. Neopterin düzeylerinin ölçümü enzimimmünoassay yöntemi ve Trinity-Biotech XL tam otomatik ELISA kit aleti ve neopterin IBL kiti ile gerçekleştirildi. Bulgular. Tüberküloza bağlı oluşan plevral sıvıdaki neopterin düzeyi malignite ve konjestif kalp yetmezliğine bağlı olanlarınkine göre anlamlı derecede yüksek bulundu (p<0,001). Konjestif kalp yetmezliği ve maligniteye bağlı plevral sıvıların neopterin düzeyleri benzer bulundu (p=0,920). Yaş ve cinsiyete göre neopterin düzeylerinde anlamlı değişiklik bulunmadı (p>0,05). Sonuçlar. Tüberküloz plörezide malignite ve konjestif kalp yetmezliğine göre plevral sıvıdaki neopterin düzeyi daha fazla artmaktadır. Bu nedenle, plevral sıvıda neopterin ölçümü tüberküloz plörezi tanısında kullanılabilecek yararlı bir yöntem olabilir.

Keywords

Neopterin; plevral efüzyon; tüberküloz plörezi

References

  • Lin C-M, Lin S-M, Chung F-T, Lin H-C, Lee K-Y, et al. Amplified Mycobacterium Tuberculosis Direct Test for Diagnosing Tuberculous Pleurisy. A Diagnostic Accuracy Study. PLoS ONE 2012; 7(9): e44842. doi:10.1371/journal. pone.0044842
  • Huber C, Batchelor JR, Fuchs D, Hausen A, Lang A, Niederwieser D, et al. Immune response-associated production of neopterin. Release from macrophages primarily under control of interferon-gamma. J Exp Med. 1984 Jul 1;160(1):310-6.
  • Valdes L, Pose A, San Jose E, Marti nez Vazquez JM. Tuberculous pleural effusions. Eur J Intern Med 2003; 14: 77–88.
  • Liam CK, Lim KH, Wong CM. Causes of pleural exudates in a region with a high incidence of tuberculosis. Respirology 2000;5: 33–38.
  • Tanrıkulu AÇ, Abakay A, Abakay Ö, Alp A. Diyarbakır ilinde tüberküloz insidansını etkileyen faktörler. Tüberküloz ve Toraks Dergisi 2007; 55(1): 18-23
  • Bahar B, Demir R, Özesmi M. Kayseri Nuh Naci Yazgan Göğüs Hastalıkları Hastanesi’nde yatan son 8 yıllık vakaların analizi. Tüberküloz ve Toraks 1989;37:59
  • Greco S, Rulli M, Girardi E, Piersimoni C, Saltini C. Diagnostic accuracy of in-house PCR for pulmonary tuberculosis in smear-positive patients: meta-analysis and metaregression. J Clin Microbiol 2009; 47:569-76.
  • Karalezli A, Gündoğdu C, Samurkaşoğlu B, Dursun G, Bener B, Uğur P. Tüberküloz plörezi tanısında gamma interferonun rolü “Adenozin deaminaz ile karşılaştırılması”. Solunum Hastalıkları. 1994; 5: 233-41.
  • Wongtim S, Silachamroon U, Ruxrungtham K, Udompanich V, Limthongkul S, Charoenlap P et al. Interferon gamma for diagnosing tuberculous pleural effusion. Thorax 1999; 54: 921-4.
  • Light R W, MacGregor M I, Luchsinger P C, Ball W C. Pleural effusions: The diagnostic seperation of transudates and exudates. Ann Intern Med 1972;77:507-13.
  • Chakko S C, Caldwell S H, Sforza P P. Treatment of conjestive heart failure: its effect on pleural fluid chemistry. Chest 1989;95:978-82.
  • Shinto RA, Light RW. The effects of diüresis upon the characteristics of pleural fluid in patients with congestive heart failure. Am Rev Respir Dis 1988;137:458.
  • Romero-Candeira S, Fernández C, Martín C, Sánchez-Paya J, Hernández L. Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure. Am J Med 2001;110:681-6.
  • Huber C, Batchelor JR, Fuchs D, Hausen A, Lang A, Niederwieser D, et al. Immune response – associated production of neopterin: relase of macrophages primarily under the control of interferongamma. J Exp. Med 1984; 160: 310 – 16.
  • Werner ER, Bichler A, Daxenbichler G, Fuchs D, Fuith LC, Hausen A, et al. Determination of neopterin in serum and urine. Clin Chem 1987; 33: 62–66.
  • Cok G, Parıldar Z, Basol G, Kabaroglu C, Bayindir U, Habif S, et al. Pleural fluid neopterin levels in tuberculous pleurisy. Clin Biochem. 2007 Aug;40(12):876-80.
  • Yadav AK, Sharma V, Jha V. Association between serum neopterin and inflammatory activation in chronic kidney disease. Mediators Inflamm. 2012; Article ID 476979, 6 pages doi: 10.1155/2012/476979.
  • Lhee HY, Kim H, Joo KJ, Jung SS, Lee KB. The clinical significance of serum and urinary neopterin levels in several renal diseases. J Korean Med Sci. 2006;21(4):678
  • Baganha MF, Mota-Pinto A, Pêgo MA, Marques MA, Rosa MA, Cordeiro AJ. Neopterin in tuberculous and neoplastic pleural fluids. Lung 1992;170:155-161.
  • Immanuel C, Swamy R, Kannapiran M, Vijayalakshmi S, Sundaram V, Jagannath K,. et al. Neopterin as a marker for cell-mediated immunity in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis. 1997 Apr;1:175-80.
There are 20 citations in total.

Details

Primary Language English
Journal Section Clinical Sciences
Authors

Faysal Duksal

İsa Döngel

Fatma Duksal This is me

Armağan Hazar This is me

Publication Date September 8, 2013
Published in Issue Year 2013 Volume: 2 Issue: 2

Cite

APA Duksal, F., Döngel, İ., Duksal, F., Hazar, A. (2013). Place of neopterin level in the differential diagnosis of tuberculosis pleurisy. Basic and Clinical Sciences, 2(2), 65-70. https://doi.org/10.12808/bcs.v2i2.27
AMA Duksal F, Döngel İ, Duksal F, Hazar A. Place of neopterin level in the differential diagnosis of tuberculosis pleurisy. Basic and Clinical Sciences. September 2013;2(2):65-70. doi:10.12808/bcs.v2i2.27
Chicago Duksal, Faysal, İsa Döngel, Fatma Duksal, and Armağan Hazar. “Place of Neopterin Level in the Differential Diagnosis of Tuberculosis Pleurisy”. Basic and Clinical Sciences 2, no. 2 (September 2013): 65-70. https://doi.org/10.12808/bcs.v2i2.27.
EndNote Duksal F, Döngel İ, Duksal F, Hazar A (September 1, 2013) Place of neopterin level in the differential diagnosis of tuberculosis pleurisy. Basic and Clinical Sciences 2 2 65–70.
IEEE F. Duksal, İ. Döngel, F. Duksal, and A. Hazar, “Place of neopterin level in the differential diagnosis of tuberculosis pleurisy”, Basic and Clinical Sciences, vol. 2, no. 2, pp. 65–70, 2013, doi: 10.12808/bcs.v2i2.27.
ISNAD Duksal, Faysal et al. “Place of Neopterin Level in the Differential Diagnosis of Tuberculosis Pleurisy”. Basic and Clinical Sciences 2/2 (September 2013), 65-70. https://doi.org/10.12808/bcs.v2i2.27.
JAMA Duksal F, Döngel İ, Duksal F, Hazar A. Place of neopterin level in the differential diagnosis of tuberculosis pleurisy. Basic and Clinical Sciences. 2013;2:65–70.
MLA Duksal, Faysal et al. “Place of Neopterin Level in the Differential Diagnosis of Tuberculosis Pleurisy”. Basic and Clinical Sciences, vol. 2, no. 2, 2013, pp. 65-70, doi:10.12808/bcs.v2i2.27.
Vancouver Duksal F, Döngel İ, Duksal F, Hazar A. Place of neopterin level in the differential diagnosis of tuberculosis pleurisy. Basic and Clinical Sciences. 2013;2(2):65-70.