Quantiferon-TB Gold is a new alternative to the tuberculin skin test that utilises synthetic peptides representing M. tuberculosis antigens ESAT-6, CFP-10, TB7.7 and upon incubation with whole blood IFN-γ is released from pre-sensitised T cells and can be measured by ELISA. This is a retrospective review and database search of the results of quantiferon – TB testing (QFT) on uveitis patients over a period of three years. This included all 343 patients tested for TB with QFT. For blood collection the authors used specialised blood collection tubes provided with the QFT intube test including a nil control tube an M. tuberculosis complex antigen tube and a mitogen tube the latter serving as a positive control. Of the 343 tested patients overall 80 (23.3 %) were positive and 253 (73.8%) negative (and non-conclusive for 10 patients). In 43 out of the 80 QFT+ patients the authors presumed a diagnosis of TB due to other clinical patterns such as radiologic findings, systemic diseases, exposure of a TB patient in the past or urinary tract TB. In the remaining 37 QFT+ patients another associated disease explaining their uveitis was detected (33 with sarcoidosis, one each with Behcet’s, toxoplasmosis, spondyloarthropathy, multifocal chorioretinitis and panuveitis). QFT was positive in nearly a fourth of the uveitis patients especially in the subgroup of intermediate, posterior and panuveitis. Anatomic localisation of the patients who tested positive were distributed as anterior n=12 (15%), intermediate n=22 (27.5%), posterior n=26 (32.5%) and panuveitis n=18 (22.5%). Of the 43 QFT+ patients, 16 were treated with full therapy following World Health Organisation (WHO) recommendations. QFT is a helpful tool in diagnosing uveitis but gives surprisingly high numbers of positives in 
uveitis patients not sufficiently explained by immigrant status of 
the patients. This raises questions regarding treatment implications. 

Three years of experience with quantiferon-TB Gold Testing in patients with uveitis.
Jakob E, Zimmerman S, Dalpe AH, et al.
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Nikolaos D Georgakarakos

Moorfields Eye Hospital, London, UK.

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