A patient with active tuberculosis can have a negative QuantiFERON-TB Gold test if certain conditions are present.
Patient selection: active tuberculosis with negative QuantiFERON-TB Gold test
Risk factors for a false negative test:
(1) older adult (>= 60 years)
(2) lymphocytopenia
(3) signs of malnutrition (low serum albumin, other)
(4) severe comorbid illness
(5) immunosuppression
Some younger patients without concurrent illness may have negative tests and these patients may not be able to produce sufficient inteferon-gamma to give a positive result.
Differential diagnosis:
(1) specimen mislabelling
(2) error in test performance
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