Abstract Ref Number = APCP1207
THE ROLE OF INTERFERON GAMMA RELEASE ASSAY (IGRA) AND RADIOLOGY CONFIRM IN DIAGNOSTICS OF OSTEOMYELITIS TB IN CHILDREN
Hirsa Agriani,Bakhtiar Bakhtiar
Syiah Kuala University
Background : As compared to pulmonary Tuberculosis (TB), osteomyelitis TB is a very rare disease comprising 1-3 % of the population of TB patients. Only 1/3 of patients with tuberculosis of the bone are diagnosed with active pulmonary disease.Osteomyelitis TB is a rare disease in young age. In this age group, cystic lesion in osteomyelitis TB usually involve the metaphysis of the peripheral long bones. Osteoclasts as bone macrophages will be higly active in osteomyelitis TB. Macrophages will release IFN-? in large quantities so that Interferon gamma Release Assay (IGRA) can be a diagnostic method.
Case Presentation Summary : In Zainoel Abidin Hospital, Banda Aceh, a boy,7 year old, with malnutrition condition, with complaints of wound surgery that has not been recovered and produce yellowish liquid since 3 month ago after surgery dislocation hip joint sinistra. Patients can not walk due to pain in the hip joint with swelling and redness. Fever ups and down since 3 months ago. Cough since 2 month ago, the history of contact with tuberculosis patients is unclear. On physical examination obtained enlargement of colii lymph nodes, swelling of bone/ joint in pelvis and knee has not been found. X ray represent suspect pulmonary tuberculosis with left pleura effusion. Pelvic AP X ray represent osteopenia periarticular, cortical irregular, lytic lesion of the ilium, ischium sinistra, acetabulum sinistra, periosteal bone formation. IGRA examination results positive.
Learning Points/Discussion : When scoring TB can not be applied absolutely, osteomyelitis TB hard to diagnose, but IGRA and Radiology can be used as an alternative for diagnostic. There is an image of bone damage and cystic lesion from X ray, also IFN-? in children with osteomyelitis TB because macrophage activity is highly increasing. Based on that, pediatricians should consider this diagnostic method.
Keywords: Osteomyelitis TB IFN-? Radiology diagnostics IGRA