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在儿科Kawasaki疾病中不确定的QuantiFERON结果:炎症预测因素和诊断影响

Koji Yokoyama¹, Mitsukazu Mamada¹

¹Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, JPN.

|August 18, 2025

概括

不确定的QuantiFERON®-TB Gold Plus (QFT) 结果在患有与炎症相关的川崎病 (KD) 的儿童中很常见. 考虑测试时间和替代方案,以对KD患者进行准确的结核病查.

科学领域:

儿童传染病儿童传染病
免疫学免疫学免疫学
诊断试验开发诊断试验开发

背景情况:

像QuantiFERON®-TB Gold Plus (QFT) 这样的干扰素-释测试 (IGRA) 对儿童结核病查至关重要.
不确定的QFT结果构成诊断挑战,特别是在患有川崎病 (KD) 的儿科患者中,由于系统性炎症可能导致T细胞功能障碍.

研究的目的:

确定与儿科患者不确定的QFT结果相关的临床和实验室因素.
在被诊断患有川崎病的儿童中专门调查这些因素.

主要方法:

来自第三级医疗中心的147个儿科QFT测试的回顾性分析.
患者之间的临床特征和实验室参数的比较,不确定的和负面的QFT结果.
亚组分析侧重于患有KD的儿童.

主要成果:

总体而言,20.4%的儿科QFT测试是不确定的,其中80%是KD患者.
在KD小组中,与负结果相比,不确定的结果与较高的C-反应蛋白和较低的血清白蛋白水平相关.
在其他实验室参数中,两组之间没有发现显著差异.

结论:

在儿科KD的急性炎症阶段,QFT可能会产生不确定的结果,可能是由于炎症诱导的T细胞抑制.
临床医生应仔细考虑在KD患者中IGRA测试的时间.
替代测定 (例如,T-SPOT.TB) 和补充诊断工具可能是必要的可靠的结核病查在这个人群.

关键词:

不确定的不确定的干扰素-释放试验 (IGRA) 是一种干扰素-释放试验.对于t点的中间阳性.卡瓦萨基病 (KD) 是一种结核病感染结核病感染

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