Novel tests for diagnosing tuberculous pleural effusion: what works and what does not?

• Published in: The European respiratory journal Vol. 31; no. 5; pp. 1098 - 1106
• Main Authors: Trajman, A, Pai, M, Dheda, K, van Zyl Smit, R, Zwerling, A. A, Joshi, R, Kalantri, S, Daley, P, Menzies, D
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01-05-2008; Maney
• Subjects: Bacterial diseases; Biological and medical sciences; Biomarkers - analysis; Human bacterial diseases; Humans; Immunoassay; Infectious diseases; Inflammation Mediators - analysis; Medical sciences; Mycobacterium tuberculosis - immunology; Mycobacterium tuberculosis - isolation & purification; Nucleic Acid Amplification Techniques; Pleural Effusion - microbiology; Pleurisy - diagnosis; Pleurisy - immunology; Pleurisy - microbiology; Pneumology; Respiratory system : syndromes and miscellaneous diseases; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Pleural - diagnosis; Tuberculosis, Pleural - immunology; Respiratory disease; Pleural effusion; Biological marker; Mycobacterial infection; Infection; Sensitivity; Specificity; Tuberculosis; Pleurisy; Bacteriosis; Biomarkers; pleuritis; Pleural disease; Diagnosis; Pneumology
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.00147507

Tuberculous pleuritis is a common manifestation of extrapulmonary tuberculosis and is the most common cause of pleural effusion in many countries. Conventional diagnostic tests, such as microscopic examination of the pleural fluid, biochemical tests, culture of pleural fluid, sputum or pleural tissue, and histopathological examination of pleural tissue, have known limitations. Due to these limitations, newer and more rapid diagnostic tests have been evaluated. In this review, the authors provide an overview of the performance of new diagnostic tests, including markers of specific and nonspecific immune response, nucleic acid amplification and detection, and predictive models based on combinations of markers. Directions for future development and evaluation of novel assays and biomarkers for pleural tuberculosis are also suggested.