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. 2022 Jul 28:10:948862.
doi: 10.3389/fped.2022.948862. eCollection 2022.

The value of interleukin-27 for differentiating tuberculous pleural effusion from Mycoplasma pneumoniae pneumonic effusion in children

Hui Xu  1 , Haiming Yang  1 , Jinrong Liu  1 , Hui Liu  1 , Xiaolei Tang  1 , Huimin Li  1 , Siyu Cai  2 , Shunying Zhao  1
Affiliations

The value of interleukin-27 for differentiating tuberculous pleural effusion from Mycoplasma pneumoniae pneumonic effusion in children

Hui Xu et al. Front Pediatr. .

Abstract

Objectives: The early diagnosis of tuberculous pleural effusion (TPE) is challenging due to the difficulty of isolating Mycobacterium tuberculosis, and pleural biomarkers are an optional choice. Recent studies showed that interleukin-27 (IL-27) appears to be a new accurate biomarker for TPE in adults and no related studies were reported in children. In this study, we aimed to evaluate the potential value of IL-27 in pediatric tuberculous pleurisy by detecting its levels in pleural fluid and serum.

Methods: A total of 48 children with TPE and 64 children with severe Mycoplasma pneumoniae (MP) pneumonic effusion (SMPPE) were enrolled in this study. IL-27 concentrations were measured in serum and pleural fluid. The diagnostic yield of IL-27 was evaluated using receiver operating characteristic (ROC) curves.

Results: The level of p-IL-27 in TPE showed statistically no significant difference when compared with SMPPE (p > 0.05). However, pleural fluid IL-27 (p-IL-27) / serum IL-27 (s-IL-27) ratio in TPE were significantly much higher than those in SMPPE (p < 0.05). By the analysis of the ROC curves, the diagnostic sensitivity and specificity of the p-IL-27/s-IL-27 ratio were 100% and 48.44%, respectively (cutoff value of 1.0280). The area under the ROC curve for p-IL-27/s-IL-27 was 0.7295.

Conclusion: Pleural fluid IL-27 alone was not accurate in distinguishing pediatric TPE from SMPPE, which was different from the diagnostic value of IL-27 in adult studies due to the different disease spectra between children and adults. Our results implied that the p-IL-27/s-IL-27 ratio had a potential value in distinguishing TPE from SMPPE. However, the specificity of IL-27 was relatively lower and it is necessary to find a more specific marker in tuberculous pleurisy of children.

Keywords: diagnosis; interleukin-27 (IL-27); mycoplasma; pleural effusion; tuberculous pleurisy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
ROC curve of p-IL-27/s-IL-27 for differential diagnosing TPE from SMPPE.
See this image and copyright information in PMC

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