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Rev Esp Quimioter ; 32(5): 445-450, 2019 Oct.
Artículo en Español | MEDLINE | ID: mdl-31523944

RESUMEN

OBJECTIVE: The immunosuppressive therapies in the treatment of the immune-mediated inflammatory diseases (EIMI) predispose individuals to the tuberculosis, so the screening of latent tuberculosis infection (ITL) and the treatment reduces the likelihood of a progression to an active tuberculosis. The aim of the study was to analyze the concordance between the test of the tuberculin (PT) and "Interferon Gamma Release Assay-IGRA" in relation to the type of EIMI and the immunosuppressive treatment (IS). METHODS: Transversal study of patients with EIMI candidates or in treatment IS forwarded to the ITL screening, from April 2017 until May 2018. The outcome variables were PT and IGRA. The explicative variables were: EIMI, IS, age, gender, prior BCG vaccination and tuberculosis risk factors. RESULTS: A total of 146 patients were analyzed (33[22.6%] vaccinated with BCG, 1 [0.7%] with a pre-diagnosis of tuberculosis, and 22 [15.1%] from an endemic country). Kappa index (k) was 0,338 between PT and IGRA for the whole sample. A lower concordance was found in patients with the Crohn's disease (k=0.125), in the ones treated with corticosteroids (k=0.222), vaccinated with BCG (k=0.122) and in patients from tuberculosis endemic countries (k=0.128). CONCLUSIONS: The concordance between PT and IGRA is affected in patients with EIMI, and to a greater extent to patients with the inflammatory bowel disease, with the corticotherapy, with the BCG vaccination, or in the ones from endemic countries.


Asunto(s)
Enfermedades del Sistema Inmune/tratamiento farmacológico , Inmunosupresores/efectos adversos , Ensayos de Liberación de Interferón gamma , Tuberculosis Latente/diagnóstico , Prueba de Tuberculina , Corticoesteroides/efectos adversos , Corticoesteroides/uso terapéutico , Adulto , Factores de Edad , Artritis Reumatoide/tratamiento farmacológico , Vacuna BCG/administración & dosificación , Vacuna BCG/efectos adversos , Enfermedad de Crohn/tratamiento farmacológico , Estudios Transversales , Femenino , Humanos , Huésped Inmunocomprometido , Inmunosupresores/uso terapéutico , Ensayos de Liberación de Interferón gamma/estadística & datos numéricos , Tuberculosis Latente/prevención & control , Masculino , Persona de Mediana Edad , Psoriasis/tratamiento farmacológico , Sensibilidad y Especificidad , Prueba de Tuberculina/estadística & datos numéricos
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