Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

Scand J Infect Dis. 2004;36(6-7):499-501. doi: 10.1080/00365540410015222.

Abstract

A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case of tuberculosis. We suggest that RD1 based tests are evaluated further in immunocompromised patients.

Publication types

  • Case Reports

MeSH terms

  • Antigens, Bacterial / genetics
  • Bacterial Proteins / genetics
  • Dermatomyositis / drug therapy*
  • Fatal Outcome
  • Humans
  • Immunologic Tests
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use*
  • Middle Aged
  • Mycobacterium tuberculosis / classification
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / physiology*
  • Reagent Kits, Diagnostic
  • Recombinant Proteins
  • Tuberculin Test
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antigens, Bacterial
  • Bacterial Proteins
  • CFP-10 protein, Mycobacterium tuberculosis
  • ESAT-6 protein, Mycobacterium tuberculosis
  • Immunosuppressive Agents
  • Reagent Kits, Diagnostic
  • Recombinant Proteins