Possible Use of Tuberculous Recombinant Allergen Test in the Differential Diagnosis of Diseases in the Upper Lung Lobes in Adults

Abstract

The objective of the study: to evaluate the possible use of the subcutaneous test with tuberculous recombinant allergen (TRA) in the differential diagnosis of pulmonary tuberculosis localized in the upper lobes.Subjects and Methods. Data of examinations with subcutaneous TRA and Mantoux tests with 2 units in 648 patients aged 18 to 90 years with various lung pathologies and HIV-negative status and 122 healthy individuals were retrospectively analyzed. Among these subjects, the following diseases were diagnosed: tuberculosis, pneumonia, cancer, post-tuberculosis changes, and sclerotic changes after nonspecific diseases.Results. The sensitivity of TRA test in adults with tuberculous lesions in the upper lobes was 59.87%; the rate of negative responses in those without active tuberculosis was 76.0%; the sensitivity of Mantoux test with 2 units was higher and made 83.6%, but the rate of negative responses in those without tuberculosis was lower – 44.1%. TRA test is most important in the differential diagnosis of tuberculosis and pneumonia in which positive and hyperergic reactions are observed in 59.87 and 13.95% of cases, respectively.The comparative analysis of the rates for tuberculosis and post-tuberculosis changes showed no statistically significant difference in both Mantoux test (83.6 and 78.4%, respectively, p > 0.05) and TRA test (59.87 and 50.77%, respectively, p > 0.05). This indicates that these tests cannot be used to assess the activity of tuberculosis localized in the upper lobes of the lungs in adults.