Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test.
A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case of tuberculosis. We suggest that RD1 based tests are evaluated further in immunocompromised patients.
Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark. pravn@dadlnet.dk
Pernille
P
Ravn
Martin E
ME
Munk
Ase Bengaard
AB
Andersen
Bettina
B
Lundgren
Lars N
LN
Nielsen
Troels
T
Lillebaek
Inge J
IJ
Soerensen
Peter
P
Andersen
Karin
K
Weldingh
D000942:Antigens, Bacterial / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D003882:Dermatomyositis / Q000188:drug therapy*; D017809:Fatal Outcome; D006801:Humans; D007159:Immunologic Tests; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics / Q000502:physiology*; D011933:Reagent Kits, Diagnostic; D011994:Recombinant Proteins; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C117940:CFP-10 protein, Mycobacterium tuberculosis; C093276:ESAT-6 protein, Mycobacterium tuberculosis; D007166:Immunosuppressive Agents; D011933:Reagent Kits, Diagnostic; D011994:Recombinant Proteins