Variations of tuberculin skin test in patients with rheumatologic disorders and under anti-TNF treatment

Özdemir, Tayfun; Tuna, Serpil; Karataş, Özlem; Arman, Mehmet

doi:10.28982/josam.537201

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…But, in some patients, the conversion of TST results from negative to positive has been observed after treatment with anti-TNF. 87,88 By using consecutive TST during anti-TNF therapy the chance of detecting positive conversion of TST can be increased. 89 The rate of TST conversion has shown a positive correlation with the duration of receiving anti-TNFs.…”

Section: False Negative Tb Test Results In Ramentioning

confidence: 99%

“…Immunosuppressive drugs can lead to a poor response to TST and yield false‐negative results. But, in some patients, the conversion of TST results from negative to positive has been observed after treatment with anti‐TNF 87,88 . By using consecutive TST during anti‐TNF therapy the chance of detecting positive conversion of TST can be increased 89 .…”

Section: Screening For Latent Tb Infection In Ramentioning

confidence: 99%

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Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

et al. 2020

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Rheumatoid arthritis (RA) is known to be related to an elevated risk of infections because of its pathobiology and the use of immunosuppressive therapies. Reactivation of latent tuberculosis (TB) infection is a serious issue in patients with RA, especially after receiving anti-TNFs therapy. TNF blocking reinforces the TB granuloma formation and maintenance and the growth of Mycobacterium tuberculosis (Mtb). After intercurrent of TB infection, the standard recommendation is that the treatment with TNF inhibitors to be withheld despite its impressive effect on suppression of inflammation until the infection has resolved. Knowing pathways and mechanisms that are common between two diseases might help to find the mechanistic basis of this comorbidity, as well as provide us a new approach to apply them as therapeutic targets or diagnostic biomarkers. Also, screening for latent TB before initiation of an anti-TNF therapy can minimize complications. This review summarizes the shared gene signature between TB and RA and discusses the biomarkers for early detection of this infection, and screening procedures as well.

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Section: False Negative Tb Test Results In Ramentioning

confidence: 99%

Section: Screening For Latent Tb Infection In Ramentioning

confidence: 99%

Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

et al. 2020

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“…Anti-TNF alpha agents, one of the biologic DMARDs (disease modifying drugs), are widely used in rheumatology. TNF cytokine plays an important role in the immune response against mycobacteria by stimulating macrophages and increasing the release of various cytokines and chemokines [9]. It makes an important contribution to the killing of mycobacteria within the cell and to the maintenance of granulomas.…”

Section: Discussionmentioning

confidence: 99%

Reasons for requesting an interferon gamma release test from internal medicine and rheumatology clinics and evaluation of the results

2023

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Background/Aim: Tuberculosis is a disease involving many systems, such as the lung, gastrointestinal system, genitourinary system, etc. Detecting this disease in its latency significantly reduces the morbidity and mortality associated with tuberculosis. One of the tests used in latent TB screening is the interferon gamma release test. In rheumatology practices, it is routinely used to screen for latent tuberculosis infections before treatment with biological agents and Janus kinase (JAK) inhibitors, and it can also be used to exclude tuberculosis infection in clinical practice. In our study, we aimed to evaluate the reasons for requesting interferon gamma release tests and the results of this test in patients who requested it. Methods: Patients admitted to internal medicine and rheumatology outpatient clinics were retrospectively screened within the retrospective cohort study. In total, 364 patients who requested interferon gamma release testing were included in the study. Nine patients with unclear test results were excluded. Laboratory results, demographic data, reasons for requesting the interferon gamma release test, and results were evaluated. Results: The interferon gamma release test was requested by 355 patients. Of these, 266 patients (74.9%) asked for latent tuberculosis screening before treatment with biological agents and JAK inhibitors. This was followed by patients with peripheral lymphadenopathy-lung nodules, patients with unexplained elevated acute phase reactants, and patients with constitutional symptoms, respectively. Ten out of 107 patients (9.3%) had an active tuberculosis infection, while six out of ten patients (60%) had pulmonary tuberculosis, and four (40%) had extrapulmonary tuberculosis. Conclusion: The most common reason for requesting the interferon gamma release test in internal medicine and rheumatology clinics was screening for latent tuberculosis before treatment with biologic agents and JAK inhibitors. In internal medicine, it has been observed that this test can also be requested by patients with constitutional symptoms, unexplained elevated acute phase reactants, and a preliminary diagnosis of tuberculosis in order to rule out or strengthen the preliminary diagnosis.

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Variations of tuberculin skin test in patients with rheumatologic disorders and under anti-TNF treatment

Cited by 2 publications

References 22 publications

Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening

Reasons for requesting an interferon gamma release test from internal medicine and rheumatology clinics and evaluation of the results

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