title: Investigation of latent tuberculosis infection in patients with psoriasis who are candidate for receiving immunobiological drugs.
abstract: The use of tumor necrosis factor inhibitors for the treatment of patients with psoriasis has been related to a higher incidence of tuberculosis, specially the disseminated and extrapulmonary forms. Despite their efficacy, these drugs increase the risk of reactivating latent tuberculosis infection, thus requiring diagnosis of the condition before their administration. Investigation of latent tuberculosis infection with tuberculin skin test is ineffective due to its low specificity and the dubious results that it generates in patients with psoriasis. Assays based on the detection of synthesis of gamma interferon in vitro by peripheral monoclonal cells, stimulated by specific antigens (ESAT-6 and CFP-10), seem to offer better accuracy when compared to the Mantoux test in identifying latent tuberculosis infection. This diagnosis tool has demonstrated higher specificity, since it has no correlation with indirect forms of exposure to M. tuberculosis such as BCG vaccination or with infections by other mycobacteria.
authors: University of Sao Paulo, Brasil. emersonderma@terra.com.br
authors: Emerson Vasconcelos de Andrade
authors: EV
authors: Lima
authors: Mariana de Andrade
authors: Mde A
authors: Lima
authors: Angela
authors: A
authors: Duarte
authors: Cláudia
authors: C
authors: Marques
authors: Gil
authors: G
authors: Benard
authors: Virgínia
authors: V
authors: Lorena
authors: Yara
authors: Y
authors: Gomes
mesh_terms: D006801:Humans; D055985:Latent Tuberculosis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D011565:Psoriasis / Q000188:drug therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use
chemical_list: D014409:Tumor Necrosis Factor-alpha