Diagnostic Test of Interleukin-4 to Determine Disease Activity in Pediatric Tuberculosis

Abstract

Background: Pediatric tuberculosis (TB) is difficult to assess because clinical manifestations are often nonspecific and microbiological confirmation is limited. Interleukin-4 (IL-4), a Th2 cytokine, may reflect immune imbalance in active TB. Objective: To evaluate the diagnostic performance of IL-4 for determining pediatric TB activity. Methods: IL-4 levels were measured in 46 pediatric TB patients, consisting of 31 active TB and 15 latent/non-active TB cases. Disease activity was determined by chest radiograph findings. Diagnostic performance was analyzed using receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, and specificity. Results: The AUC was 0.624 (95% confidence interval: 44.0%-80.7%; p=0.178). The optimal IL-4 cut-off was 0.44750 pg/mL, with sensitivity of 67.7% and specificity of 60.0%. Mean IL-4 levels were higher in active TB than in latent/non-active TB. Conclusion: IL-4 may serve as a supportive biomarker for pediatric TB activity, but its diagnostic value is limited and requires further validation.