Document Detail


Latent Tuberculosis in Rheumatoid Arthritis: Evaluating Cellular Response and High-Resolution Computed Tomography.
MedLine Citation:
PMID:  22401741     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: The diagnosis of latent tuberculosis (LTB) in patients with rheumatoid arthritis (RA) has become important with the introduction of anti-tumor necrosis factor (anti-TNF-α) agents and the appearance of active tuberculosis cases in these patients. The tuberculin skin test (TST) has limited value in patients with RA. Tests based on the release of interferon-gamma (IFN-γ) are being studied, but their role has not been well established for this group of patients. OBJECTIVES: To compare the diagnosis of LTB in patients with RA by using cellular immune response to the TST and T.SPOT-TB. Additionally, findings of tomography studies compatible with LTB were used. METHODS: Clinical evaluation, TST, T.SPOT-TB and high-resolution computed tomography (HRCT) in a group of patients with RA at the University Hospital of the Federal University of Goiás. RESULTS: Response to the TST was lower in patients with RA (13.5%) compared to the predicted values of the general population. T.SPOT-TB identified a higher number of patients with LTB than the TST (36.8%). HRCT showed changes compatible with LTB in 52.9% of the patients, including 8 of the 11 patients with negative TST and T.SPOT-TB. CONCLUSIONS: The TST by itself is insufficient to diagnose LTB. A higher number of positive results were obtained with T.SPOT-TB when compared to the TST. Nevertheless, it was negative in a large percentage of patients with tomography findings consistent with LTB. HRCT is readily available in most large health-care centers and it could be incorporated into the diagnostic strategy for LTB in patients with RA.
Authors:
Daniela G S Tannus Silva; Bruna Daniella Silva; Pedro Paulo Torres; Pedro José Santana Junior; Ana Paula Junqueira-Kipnis; Marcelo Fouad Rabahi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-6
Journal Detail:
Title:  Archivos de bronconeumologia     Volume:  -     ISSN:  1579-2129     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0354720     Medline TA:  Arch Bronconeumol     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.
Affiliation:
Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Brasil.
Vernacular Title:
Tuberculosis latente en la artritis reumatoide. Evaluación de la respuesta celular y tomografía computarizada de alta resolución.
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