The significance of skin immunological tests in the diagnosis of extrapulmonary tuberculosis in children
Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus
Vestnik VGMU. 2020;19(6):115-121.
Objectives. To determine the diagnostic value of the tuberculinodiagnosis method and the skin test with the recombinant tuberculosis allergen (Diaskintest) in the diagnosis of extrapulmonary tuberculosis in children.
Material and methods. Tuberculin sensitivity was analyzed based on the results of the Mantoux test with 2 TE of tuberculin PPD-L in standard dilution and the response to Diaskintest in 53 children with extrapulmonary tuberculosis: 32 patients who were admitted to the inpatient stage of treatment with an established diagnosis of active extrapulmonary tuberculosis and 21 patients with a course of completed treatment. The study also included 12 children with complicated BCG vaccination: 8 children with regional left-sided axillary BCG-lymphadenitis and 4 children with BCG-ostitis.
Results. The article presents the data of a comparative analysis of the informativeness of the skin immunological tests (tuberculinodiagnosis and the skin test with the recombinant tuberculosis allergen – Diaskintest (DST)) for the timely detection of extrapulmonary tuberculosis in children. Patients with active extrapulmonary tuberculosis responded positively to tuberculin in 37.5% of cases, and to DST – in 73.5% of cases (p<0.05). Patients with cured extrapulmonary tuberculosis responded positively to tuberculin in 14 (62.5%) cases and to DST – in 7 cases (33.3%) (p<0.05). All children with a complicated course of BCG vaccination had a negative reaction to DST, while 11 (91.7%) children had a normergic response to tuberculin (p<0.001).
Conclusions. The low diagnostic significance of tuberculinodiagnosis and high informative value of Diaskintest in the diagnosis of active extrapulmonary tuberculosis and its differential diagnosis with BCG complications in children have been established.
Key words: extrapulmonary tuberculosis, children, diagnosis, tuberculin, Diaskintest.
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Information about authors:
Pozdnyakova A.S. – Doctor of Medical Sciences, professor of the Chair of Pulmonology & Phthisiology, Belarusian Medical Academy of Post-Graduate Education.