Comparison of laboratory parameters in differentiation of tuberculosis and sarcoidosis

Introduction: The clinical, radiological and pathological similarities between pulmonary sarcoidosis and tuberculosis(TB) can make disease differentiation challenging.We aimed to investigate and compare the cytokines profiles between sarcoidosis and tuberculosis patients. Materials and Methods: In 24 patients with pulmonary TB and 34 patients with sarcoidosis, levels of interleukin 4, 13, neutrophil lymphocyte ratio, albumin, ESR and serum calcium were assessed and compared with control group.Results: The mean age was 47.71 ± 10.88 and 55.25 ± 21.58 ys in the sarcoidosis and tuberculosis (P> 0.05). The mean ESR in sarcoidosis patients was 21.45 ± 13.37mm / hr and 41.4 ± 17 mm / hr in the TB group, (P<0.05). The percentage of peripheral blood lymphocytes in sarcoidosis and TB patients were 28.02 ± 12.20 and 21.41 ± 12.49 respectively, which was significantly higher among patients with sarcoidosis.The ratio of neutrophils to lymphocytes was also 2.4 ± 1.6 and 4.4 ± 2.9, respectively, which showed a significant difference among the groups. The rock curve showed that the diagnostic cut off of ESR level, serum calcium and neutrophil / lymphocyte ratio are valuable due to sig. differentiation.We found that the serum levels of IL-4 of sarcoidosis patients was significantly higher than TB patients (P=0≤0.5). Moreover, the levels of IL-13 in serum of TB patients was indistinguishable between control subjects and however very significantly was higher in sarcoidosis patients (P=0≤0.01) which was significantly different from healthy volunteers. Besides, in TB patients had significantly lower levels of the Th2 cytokine interleukin-4 (IL-4) than those with sarcoidosis (P=0.004). Conclusions: These data indicated that cytokines arrays and analysis could helpful to distinguish sarcoidosis from TB. Systemic TH1/TH2 cytokine differences between sarcoidosis and TB may also underlie different disease outcomes to similar respiratory stimuli.

کلیدواژه ها:

Interleukin ، Sarcoidosis ، Sensitivity ، Specificity ، Tuberculosis.