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- Title
A comparative analysis of tuberculosis in vitro screening in pemphigus patients selected for treatment with rituximab.
- Authors
Jałowska, Magdalena; Gornowicz-Porowska, Justyna; Seraszek-Jaros, Agnieszka; Kaczmarek, Elżbieta; Bowszyc-Dmochowska, Monika; Bartkiewicz, Paweł; Dmochowski, Marian
- Abstract
Introduction: Patients qualified for the Polish government programme of treating severe pemphigus diseases with rituximab (RTX) available in 2018-2019 had to meet numerous criteria, including no active infectious disease. Aim: The clinical usefulness of tuberculosis screening with the QuantiFERON-TB Gold Plus (QFT-Plus) in native pemphigus patients selected for RTX treatment was statistically evaluated. Material and methods: Eighteen pemphigus patients were examined with QFT-Plus prior to the intended RTX therapy. Ninety hospital employees examined with QFT-Plus due to contact with a cleaning worker who was diagnosed with active pulmonary tuberculosis were the control group. Results: Six of 18 pemphigus patients had a positive QFT-Plus test result, one indefinite result and one initially indefinite and then negative. In the control group, 26 of 90 employees had a positive test result and none had an indefinite result. Statistical analysis by Fisher's exact test showed no statistically significant difference in QFT-Plus positive results between the groups (p = 0.5577). Only in 1 patient with recurrent mucocutaneous pemphigus vulgaris previously treated with traditional immunosuppression, lung changes were detected by computed tomography. No employee had any changes in the chest radiograph. Conclusions: Prior immunosuppression and autoimmunity might be the cause of indefinite test results, but they do not seem to increase positive results. In the native population, the QFT-Plus screening reveals a significant population exposure to M. tuberculosis infection independent of pemphigus autoimmunity, and such screening can be a starting point for identifying patients requiring anti-tuberculosis drug prophylaxis before combined RTX-glucocorticosteroid treatment.
- Subjects
RITUXIMAB; PEMPHIGUS treatment; TUBERCULOSIS diagnosis; IMMUNOSUPPRESSION; AUTOIMMUNITY; PREVENTIVE medicine
- Publication
Advances in Dermatology & Allergology / Postępy Dermatologii i Alergologii, 2021, Vol 38, Issue 4, p611
- ISSN
1642-395X
- Publication type
Article
- DOI
10.5114/ada.2021.108904