Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis

Abstract

In this editorial, we comment on an article published in a recent issue of the World Journal of Clinical Cases. There is a pressing need for reliable tools for diagnosing tuberculosis (TB) of the gastrointestinal tract. Despite advancements in the diagnosis and treatment, TB remains a global health challenge. Ali et al demonstrated that TB may mimic gastrointestinal conditions, such as gastric outlet obstruction, causing a delay in the diagnosis. Furthermore, the latter complication is frequently observed during infections, including Helicobacter pylori, and rarely is related to TB, as in the presented case. In line with this, we think that laboratory tests based on interferon-gamma release assays can be a helpful tool for diagnosing latent TB paced in the gastrointestinal tract. Innovative strategies and approaches for diagnosing latent/active extra pulmonary TB are crucial for establishing the diagnosis early and enhancing treatment strategies to mitigate the global burden of TB.

Keywords: Tuberculosis, Gastrointestinal tuberculosis, Interferon-gamma release assay, IGRA, Primary gastroduodenal tuberculosis, Gastric outlet obstruction, Case report

Core Tip: The diagnosis of abdominal tuberculosis (TB) is frequently delayed since there are no identifiable clinical signs and symptoms, and the illness might resemble other intra-abdominal disorders. In line with this, the most prevalent causes of gastric outlet obstruction are peptic ulcer disease and stomach cancer, and when excluded, TB infection should be added as a differential diagnosis. Assays of interferon-gamma release (IGRAs) have become a crucial diagnostic tool for latent TB infection. IGRAs have also been used to potentially distinguish between mimics such as Crohn's disease or other ascites-causing conditions and abdominal TB. Given that they are unaffected by the Bacille Calmette-Guérin immunization, these are considered beneficial.