TY - JOUR T1 - Interleukin 27 could be useful in the diagnosis of tuberculous pleural effusions JF - Respiratory Care DO - 10.4187/respcare.02749 SP - respcare.02749 AU - Luis Valdés AU - Esther San José AU - Lucía Ferreiro AU - Antonio Golpe AU - Francisco Gude AU - José M. Álvarez-Dobaño AU - Marco F. Pereyra AU - María E Toubes AU - Francisco J. González-Barcala Y1 - 2013/08/20 UR - http://rc.rcjournal.com/content/early/2013/08/20/respcare.02749.abstract N2 - Introduction: The diagnosis of tuberculous pleural effusions (TBPE) has some limitations. Objective: To evaluate the efficacy of Interleukin-27 (IL-27) in the diagnosis of TBPE. Methods: A total of 431 pleural effusions were classified as tuberculous (n=70), neoplastic (n=146), parapneumonic (n=58), empyemas (n=28), miscellaneous (n=41), and transudates (n=88). IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ) and the ADA·IL-27 and ADA-2·IL-27 products were measured in all of the fluids. The diagnostic yield of IL-27 was evaluated using operating characteristics (ROC) analysis. Results: With a cut-off point of 0.55 ng/mL, IL-27 had a sensitivity of 91.4% and a specificity of 85.1%, which were significantly less than the rest of the parameters. The area under the ROC curve (0.963) was also significantly less than the rest of the markers, except for IFNγ. However, IL-27 improves the sensitivity of the ADA and ADA-2 through ADA·IL-27 and ADA-2·IL-27 products (100% for both). Conclusions: IL-27 is less efficient than ADA and ADA-2 in the diagnosis of TBPE. However, using the products of ADA·IL-27 and ADA-2·IL-27, helps to improve the diagnostic sensitivity of ADA and ADA-2, thus it could be useful in situations of high clinical suspicion and low levels of ADA. A value above the cut-off point of the latter is practically diagnostic of TBPE. ER -