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A clinicopathological profile and role of newer methods in diagnosis of paediatric tubercular lymphadenopathy


International Clinical Pathology Journal
Saqib Ahmed, Shariq Ahmed, Uzma Tayyaba, Ruhi Hasan

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Abstract

Objectives: Lymphadenopathy is a common finding in children and poses a diagnostic dilemma. There are various conventional methods for the diagnosis of tubercular lymphadenopathy with some newer methods like GeneXpert Assay recently introduced. This study emphasizes the role of newer diagnostic methods and a detailed clinicopathological profile of paediatric patients. Methods: This was a four-year prospective study including a total of 512 children under 13 years who were clinically suspected of tubercular lymphadenopathy were included. FNAC followed by ZN staining, Modified bleach method, MTP 64 Antigen testing, GeneXpert MTB/RIF Assay analysis and Culture was performed on the adequate samples and studies of comparison were done. Results: Sensitivity, specificity and diagnostic accuracy of different methods were compared and GeneXpert outshined the other method of diagnosis with a sensitivity of 93.1%, specificity of 100 % and diagnostic accuracy of 97.5%. Interpretation & conclusions: GeneXpert essay should be included in early in the diagnostic workflow of paediatric lymphadenopathy which will potentially improve the overall detection and reduce the turn-around time, thus preventing the unnecessary delay in treatment thus reducing the overall burden of TB.

Keywords

paediatric lymphadenopathy, tuberculosis, FNAC, MTB64 antigen, modified bleach technique, geneXpert MTB/RIF assay

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