Laboratory diagnosis of pediatric tuberculosis: a review of routine tests and promising new biomarkers
Diagnóstico laboratorial da tuberculose pediátrica: uma revisão dos testes de rotina e novos biomarcadores promissores
DOI:
https://doi.org/10.33362/ries.v14i2.3590Palavras-chave:
Tuberculosis, Diagnosis, Children, Biomarkers, Laboratorial testsResumo
Despite substantial efforts for the early diagnosis of tuberculosis (TB) in children, the paucibacillary characteristic of the disease and clinical manifestations resembling other pulmonary childhood infections contribute to pediatric TB remaining a significant challenge for global public health. Overall, for children and adolescents, rapid molecular methods, culture and antigen detection in a lateral flow format, constitutes the main technology to help detect active TB and to evaluate drug resistance. In addition, with the rapid technological development, other methodologies are becoming promising for diagnosing pediatric TB. Furthermore, the recent advances in early diagnosis have shown a positive impact on the timing and effectiveness of TB treatment in children. In this way, this review aimed to summarize the laboratory tests available for children while providing insights into new biomarkers (inflammatory mediators, liquid biopsy and extracellular vesicles) in the evolving landscape of pediatric TB diagnosis.
Keywords: Tuberculosis. Diagnosis. Children. Biomarkers. Laboratorial tests.
Resumo: Apesar dos esforços substanciais para o diagnóstico precoce da tuberculose (TB) em crianças, a característica paucibacilar da doença e as manifestações clínicas semelhantes a outras infecções pulmonares da infância contribuem para que a TB pediátrica permaneça um desafio significativo para a saúde pública global. No geral, para crianças e adolescentes, métodos moleculares rápidos, cultura e detecção de antígenos em formato de fluxo lateral constituem as principais tecnologias para ajudar a detectar a TB ativa e avaliar a resistência aos medicamentos. Além disso, com o rápido desenvolvimento tecnológico, outras metodologias estão se tornando promissoras para diagnosticar a TB pediátrica. Ademais, os avanços recentes no diagnóstico precoce demonstraram impacto positivo no tempo e na eficácia do tratamento da TB em crianças. Assim, esta revisão teve como objetivo resumir os testes laboratoriais disponíveis para crianças, fornecendo também perspectivas sobre novos biomarcadores (mediadores inflamatórios, biópsia líquida e vesículas extracelulares) no cenário em evolução do diagnóstico da TB pediátrica.
Palavras-chave: Tuberculose. Diagnóstico. Crianças. Biomarcadores. Exames laboratoriais.
Resumen: A pesar de los esfuerzos sustanciales para el diagnóstico temprano de la tuberculosis (TB) en niños, la característica paucibacilar de la enfermedad y las manifestaciones clínicas que se asemejan a otras infecciones pulmonares infantiles contribuyen a que la TB pediátrica siga siendo un desafío importante para la salud pública mundial. En general, para niños y adolescentes, los métodos moleculares rápidos, el cultivo y la detección de antígenos en formato de flujo lateral constituyen la principal tecnología para ayudar a detectar la TB activa y evaluar la resistencia a los medicamentos. Además, con el rápido desarrollo tecnológico, otras metodologías están mostrando ser prometedoras para el diagnóstico de la TB pediátrica. Asimismo, los avances recientes en el diagnóstico temprano han mostrado un impacto positivo en el tiempo y la efectividad del tratamiento de la TB en niños. Por lo tanto, esta revisión tuvo como objetivo resumir las pruebas de laboratorio disponibles para niños y proporcionar perspectivas sobre nuevos biomarcadores (mediadores inflamatorios, biopsia líquida y vesículas extracelulares) en el panorama evolutivo del diagnóstico de la TB pediátrica.
Palabras clave: Tuberculosis. Diagnóstico. Niños. Biomarcadores. Pruebas de laboratorio.
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