The Interplay of Disease Modifying Anti Rheumatic Drugs and Tuberculin Skin Test

2020 ◽  
Vol 15 ◽  
Author(s):  
Zia Abdullah ◽  
Arvind Kumar ◽  
M. A. Khan ◽  
Uma Kumar ◽  
Surabhi Vyas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Steroid Use ◽  
Purified Protein Derivative ◽  
Disease Modifying

Objective:: The study was conducted to determine whether synthetic disease modifying Anti Rheumatic drugs (DMARDs) suppresses the latency of Tuberculosis (TB) infection in Rheumatoid Arthritis (RA) patients along with other variables. Methods:: This was done through Tuberculin Skin Test (TST) using Purified protein derivative (PPD) in cohort of RA Patients. The TST was taken positive when induration post PPD injection was  5mm and negative or anergic when it was < 5mm. We included 100 patients (N = 100). Results:: The prevalence of positive TST was 36%, while 64% presented a negative result. Negative TST was significantly associated with steroid usage (39.4%, 95% CI: 28.4%-51.4%). Anergic (TST negative) and non-anergic (TST positive) patients were separated in groups, and a new analysis was done with elaboration on DMARDs used. Conclusion:: Steroid use and not treatment with methotrexate or other DMARDs was associated with TST negativity and thus TST should be interpreted with caution especially before starting biologicals.

scholarly journals Tuberculin Skin Test in Spondyloarthritis: Overestimated if Rheumatoid Arthritis Guidelines for Latent Tuberculosis Are Used?

2020 ◽  
Author(s):  
Ufuk İlgen ◽  
Ömer Karadağ ◽  
Hakan Emmungil ◽  
Orhan Küçükşahin ◽  
Süleyman Serdar Koca ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Latent Tuberculosis ◽  
Disease Category ◽  
Steroid Use ◽  
Disease Characteristics ◽  
Biologic Dmard ◽  
Synthetic Dmards ◽  
And Performance

Abstract Background: Several societies published recommendations for latent tuberculosis infection (LTBI) screening before biological and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) but not for other inflammatory arthritides such as spondyloarthritis (SpA). Using RA guidelines could result in overestimating Tuberculin Skin Test (TST) positivity in SpA. This study aimed to compare the distribution of TST results in SpA and RA patients along with comparison in terms of QuantiFERON®-TB Gold In-Tube (QFT-GIT) test in a Bacillus Calmette-Guérin-vaccinated population.Methods: Adult RA (n=206) and SpA (n=392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups.Results: Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cut-off (p<0.001). QFT-GIT positivity was slighlty higher in the SpA group (15% vs 8.9%, p=0.075). QFT-GIT positivity and disease category independently predicted a 5 mm or higher TST. The two tests poorly agreed in both groups at a TST cut-off of 5 mm (κ<0.1 for both groups). Increasing the TST cut-off only slightly increased the agreement between the two tests.Conclusions: TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cut-off for both diseases could result in overestimating LTBI in SpA.

Increased detection of latent tuberculosis by tuberculin skin test and booster phenomenon in early rheumatoid arthritis patients

2015 ◽  
Vol 35 (9) ◽  
pp. 1555-1559 ◽  
Author(s):  
L. Pérez-Barbosa ◽  
J. A. Esquivel-Valerio ◽  
A. C. Arana-Guajardo ◽  
D. Vega-Morales ◽  
J. Riega-Torres ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Early Rheumatoid Arthritis ◽  
Latent Tuberculosis

Mantoux Test in Kawasaki Disease

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 161-161
Author(s):  
Alberto Bertotto ◽  
Fabrizio Spinozzi ◽  
Maurizio Radicioni ◽  
Renato Vaccaro
Keyword(s):  
Kawasaki Disease ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Acute Phase ◽  
Mantoux Test ◽  
Skin Test Reactivity ◽  
Purified Protein Derivative ◽  
Characteristic Features ◽  
Early Manifestation

Localized erythema at the site of a previous bacillus Calmette-Guérin (BCG) inoculation is a relatively specific and early manifestation of Kawasaki disease (KD),1 and redness and crusting are characteristic features at the site of BCG immunization during the acute phase of the illness.2 With these findings in mind, we evaluated the tuberculin skin test reactivity of children with KD, as determined by a commercially available (Sclavo, Siena, Italy) and intradermally injected (5 TU) purified protein derivative (PPD).

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