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IGRA testing in patients with immune-mediated inflammatory diseases: which factors influence the results?

Abstract

Diagnosis of latent tuberculosis infection in patients with immune-mediated inflammatory chronic diseases (IMIDs) can be challenged as diagnostic test reliability could be impaired by immunosuppression. We retrospectively analyzed the Quantiferon Gold-Test in-Tube (QFT-G-IT) results of all patients with IMIDs seen at the Department of Internal Medicine of Son Llàtzer Hospital, Palma de Mallorca (Spain), looking for the factors related to QFT-G-IT indeterminate results. During the study period (2008–2015), 520 patients met the inclusion criteria. Factors associated with indeterminate QFT-G-IT results in a univariate analysis were inflammatory bowel disease, disease activity, lymphopenia, and medium-to-high doses of corticosteroids. In a subsequent multivariate analysis, only lymphopenia (defined as < 1500 cells) was associated with indeterminate QFT-G-IT results. Lymphocyte count was the only factor independently associated with an increased number of indeterminate QFT-G-IT results in patients with different autoimmune diseases. Others factors such as the use of medium-to-high doses of corticosteroids should be considered before testing with QFT-G-IT.

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Correspondence to Juan González-Moreno.

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González-Moreno, J., García-Gasalla, M., Losada-López, I. et al. IGRA testing in patients with immune-mediated inflammatory diseases: which factors influence the results?. Rheumatol Int 38, 267–273 (2018). https://doi.org/10.1007/s00296-017-3852-9

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  • DOI: https://doi.org/10.1007/s00296-017-3852-9

Keywords

  • IGRA
  • Quantiferon
  • Tuberculosis infection
  • Autoimmune diseases