PT  - JOURNAL ARTICLE
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
TI  - Interleukin 27 Could Be Useful in the Diagnosis of Tuberculous Pleural Effusions
AID  - 10.4187/respcare.02749
DP  - 2014 Mar 01
TA  - Respiratory Care
PG  - 399--405
VI  - 59
IP  - 3
4099  - http://rc.rcjournal.com/content/59/3/399.short
4100  - http://rc.rcjournal.com/content/59/3/399.full
AB  - BACKGROUND: The diagnosis of tuberculous pleural effusion (TBPE) has some limitations. We studied the efficacy of interleukin-27 (IL-27) in the diagnosis of TBPE. METHODS: We measured IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ), and the ADA·IL-27 and ADA-2·IL-27 products in all the pleural effusion fluids. The diagnostic yield of IL-27 was evaluated with receiver operating characteristic curves. RESULTS: Of 431 pleural effusions, 70 were tuberculous, 146 were neoplastic, 58 were parapneumonic, 28 were empyemas, 88 were transudates, and 41 were other types. With a cutoff 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 ADA, ADA-2, IFNγ, ADA·IL-27, or ADA-2·IL-27. The area under the receiver operating characteristic curve for IL-27 (0.963) was also significantly lower than that for the other markers, except for IFNγ. However, IL-27 improved the sensitivity of 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, ADA·IL-27 and ADA-2·IL-27 improve the diagnostic sensitivity of ADA and ADA-2, and thus could be useful in situations of high clinical suspicion and low ADA level. A value above the cutoff point of the latter is practically diagnostic of TBPE.