Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil.
OBJECTIVE
Inflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil.


METHODS
We evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed.


RESULTS
We reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2).


CONCLUSIONS
Patients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients.
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil; Bahia School of Medicine and Public Health, Salvador, BA, Brazil.
Ingrid Puig
IP
Cardoso
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil. Electronic address: neoalmeida@yahoo.com.br.
Neogelia Pereira
NP
de Almeida
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil; Bahia School of Medicine and Public Health, Salvador, BA, Brazil.
Daniela Rosa
DR
Gotardo
Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
Mauricio
M
Cardeal
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil; Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
Genoile Oliveira
GO
Santana
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000276:immunology; D003424:Crohn Disease / Q000453:epidemiology / Q000276:immunology; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis*
IBD; Latent tuberculosis; TST