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Braz J Infect Dis. 2014 Jan-Feb;18(1):60-4. doi: 10.1016/j.bjid.2013.05.008. Epub 2013 Sep 20.

Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil.

Author information

1
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil; Bahia School of Medicine and Public Health, Salvador, BA, Brazil.
2
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil. Electronic address: neoalmeida@yahoo.com.br.
3
Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
4
Gastroenterology Unit, Roberto Santos General Hospital, Salvador, BA, Brazil; Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.

Abstract

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.

KEYWORDS:

IBD; Latent tuberculosis; TST

PMID:
24055308
DOI:
10.1016/j.bjid.2013.05.008
[Indexed for MEDLINE]
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