MEDIX, God. 18 Br. 101/102  •  Pregledni članak  •  Pedijatrija HR ENG

Tuberkuloza u djece – suvremene spoznajeTuberculosis in children – new knowledge

Neda Aberle

Infekcija uzrokovana bakterijom Mycobacterium tuberculosis ne mora obvezatno rezultirati bolešću. U prirodnim uvjetima procjenjuje se da svega 10% zaraženih osoba doista oboli od klinički manifestne tuberkuloze. S obzirom na to da tuberkuloza ima dug i raznolik oblik prikrivenosti u kojima nema simptoma, važno je otkriti latentnu tuberkuloznu infekciju. Izraženost bolesti ovisi o interakciji polimorfizma gena i okoline. Kad nema jasnih kliničkih, radioloških i mikrobioloških nalaza, dijagnoza se postavlja s pomoću tuberkulinskih testova te testova otpuštanja interferona in vitro, tzv. IGRA (interferon gamma release assay: QTF-G, QTF-G-IT, T-SPOT TB). Nedavno je uveden brzi dijagnostički DNA-test na tuberkulozu s pomoću određivanja DNA-mikobakterija (Xpert MTB/ Rif test). Nužno je liječenje već i latentnog oblika tuberkuloze jer se tako smanjuje pojedinačni rizik daljnjeg razvoja bolesti. 

Ključne riječi:
dijete; protutuberkulozni lijekovi; test otpuštanja interferona gama; tuberkulinski test; tuberkuloza, plućna

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 18 Br. 101/102

Infection with Mycobacterium tuberculosis need not always result in manifest disease. It is estimated that, under normal conditions, only 10% of infected persons develop clinically evident disease. Since tuberculosis has a long and diverse phase without clearly recognizable signs and symptoms, detection of latent tuberculosis is very important. Clinical expression of the disease depends on the interplay between mycobacterium, host’s genetic polymorphism and the environment. In the absence of clear clinical, radiological and laboratory evidence of infection, diagnosis can be reached by use of tuberculin (PPD) skin tests and interferon release assay (IGRA) in vitro (QTF-G, QTF-G-IT, T-SPOT TB). Recently, a rapid diagnostic DNA test based on determination of mycobacterial DNA (Xpert MTB/Rif test) has become available. The treatment of latent tuberculosis reduces the risk of disease progression. 

Key words:
antitubercular agents; child; interferon-gamma release tests; tuberculin test; tuberculosis, pulmonary