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Korean J Intern Med. 2014 Jan;29(1):76-84. doi: 10.3904/kjim.2014.29.1.76. Epub 2014 Jan 2.

Poor agreement between QuantiFERON-TB Gold test and tuberculin skin test results for the diagnosis of latent tuberculosis infection in rheumatoid arthritis patients and healthy controls.

Author information

1
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
2
Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea.
3
Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
4
Withus Medical Clinic, Goyang, Korea.

Abstract

BACKGROUND/AIMS:

We investigated the agreement between the QuantiFERON-TB Gold (QFT-Gold) test and the tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis (RA), compared with healthy controls, in Korea.

METHODS:

We recruited 64 patients with RA and 79 healthy controls at two university hospitals in South Korea. The participants underwent both the QFT-Gold test and the TST simultaneously between August 2006 and February 2009. All patients were diagnosed using the classification criteria for RA revised in 1987 by the American College of Rheumatology. Bacillus Calmette-Guérin vaccination status and current medications were evaluated, and disease activities were assessed using the Disease Activity Score in 28 joints. Eleven patients with RA produced indeterminate QFT-Gold test results and were thus excluded from the kappa analysis.

RESULTS:

Based on an induration of 10 mm in diameter as the TST cutoff value, the QFT-Gold test and TST demonstrated 75.0% agreement (κ = 0.23) in patients with RA and 75.9% agreement (κ = 0.19) in healthy controls. Among the 56 patients with RA who had negative TST results, 11 patients (17.2%) also yielded indeterminate QFT-Gold results.

CONCLUSIONS:

Our study showed poor agreement between the results of the QFT-Gold test and the TST in both RA patients and healthy controls. Based on these findings, we emphasize the importance of making clinical decisions in the diagnosis of latent tuberculosis in Koreans with or without RA.

KEYWORDS:

Arthritis, rheumatoid; Latent tuberculosis; QuantiFERON-TB Gold test; Tuberculin skin test

PMID:
24574836
PMCID:
PMC3932398
DOI:
10.3904/kjim.2014.29.1.76
[Indexed for MEDLINE]
Free PMC Article
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