The role of modern immunological tests in the differential diagnosis of paediatric tuberculosis

Today, tuberculosis (TB) remains an urgent global public healthcare challenge. According to WHO estimates, about 1.3 million child population under age 15 fell ill with tuberculosis worldwide in 2023. An estimated 166 thousand children (0–14 years of age) died for this period. The TB incidence in children and adolescents is an important prognostic indicator that reflects the overall epidemiological situation in the region. A timely detection of the health condition, when the risk of developing active TB disease becomes the highest is an important factor for the reduction of the TB incidence. The implementation of preventive measures, including preventive treatment, will be quite effective in preventing development of TB disease. In the Russian Federation, different immunological diagnostic tests are used for preventing and early detection of TB in children according to their age. That has led to a significant reduction in the incidence in not only the child and adolescent population, but also a decrease in indices in the age group of 18-25 years. An intradermal ATP test and/or alternative in vitro tests such as IGRA tests are used, among other things, as part of diagnostic and differential diagnostic measures when tuberculosis is suspected. The use of a combination of all available methods to establish an accurate diagnosis would be appropriate in the most complex diagnostic cases. The presented clinical observation highlights a rare case of calcifying fibrous tumour in a 17-year-old boy, which required a multifaceted diagnostic approach, including modern IGRA tests (TigraTest®TB), to exclude tuberculosis involving multiple systems and select the correct treatment and diagnostic strategy to verify the diagnosis.