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Urinary neopterin measurement as a non-invasive diagnostic method in pulmonary tuberculosis
1Department of Pulmonary Medicine, Gulhane Askeri Tip Akademisi, Ankara, Turkey. iyuksekol@gata.edu.tr
Setting:
Pulmonary department of a university hospital in Ankara, Turkey.
Objective:
To investigate the usefulness of neopterin in pulmonary tuberculosis (PTB) as a rapid diagnostic tool.
Design:
Neopterin concentrations in bronchoalveolar lavage fluid (BAL), serum and urine were measured in patients with PTB, with lung cancer and with pneumonia and in a healthy control group.
Results:
In the BAL of PTB patients, serum and urine levels of neopterin were significantly higher than all the other groups (P < 0.001). Compared with the lung cancer group, PTB patients had higher neopterin in BAL and urine (P < 0.05). The PTB group had higher levels not only in BAL and urine, but also in serum, than the pneumonia group (P < 0.05). Compared with the pneumonia group and the healthy controls, neopterin levels in serum and urine were significantly higher in the lung cancer group (P < 0.05). In the PTB group, patients with moderately advanced PTB according to radiographic extent had higher levels of urine neopterin than patients with minimal disease (P = 0.01).
Conclusion:
Neopterin levels in BAL, serum and particularly in urine may reflect PTB activity before exact diagnosis of the disease by culture results, and correlates with radiological extent.