Abstract
Resurgence of TB has emphasized the need for newer methods of diagnosis. Extrapulmonary tuberculosis (EPTB), being paucibacillary, is a diagnostic dilemma. The aim of the present study was to correlate IFN-γ/IL-2 with neopterin in diagnosis of EPTB. Extrapulmonary specimens from 69 clinically diagnosed cases were stained by Ziehl-Neelsen and cultured on Lowenstein-Jensen medium for Mycobacterium tuberculosis. ELISA was used to assess serum IFN-γ, IL-2 and neopterin levels. Median serum levels of IFN-γ/IL-2 and neopterin were 3.22 and 21.6nmol/L in clinically diagnosed EPTB cases and 0.52 and 4.20nmol/L in healthy controls respectively (p<0.001). Both IFN-γ/IL-2 and neopterin were significantly higher in culture positive (14.64 and 49.8nmol/L) than culture negative cases (3.01 and 17.5nmol/L) respectively (p<0.05). IFN-γ/IL-2 was significantly higher in AFB smear positive cases (8.63) than smear negative cases (3.04) (p=0.003), whereas no significant difference in neopterin levels was seen (p=0.307). A positive correlation between IFN-γ/IL-2 and neopterin was seen in EPTB cases (spearman's rho=0.453, p<0.001), whereas in healthy controls no such correlation existed (spearman's rho=0.018, p=0.884). An urgent need for research in the field of biomarkers exists to utilize them as point of care test in the diagnosis of EPTB.
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