New York Medical College, Valhalla, New York, USA.
J Am Acad Dermatol. 2011 Jul;65(1):195-7. doi: 10.1016/j.jaad.2009.12.025. Epub 2011 Apr 19.
The increased risk to patients on anti-tumor necrosis factor-alfa therapy of developing active tuberculosis supports screening of these patients for latent tuberculosis infection. The current practice of determining the presence of latent tuberculosis infection primarily, and often entirely, depends on the use of tuberculin skin testing (TST). We report a patient with psoriasis on long-term etanercept therapy who had a negative TST result and a positive interferon-gamma release assay result. Similar cases have also been found through a review of the literature. These findings suggest that TST might be unreliable during long-term anti-tumor necrosis factor-alfa therapy. QuantiFeron-TB Gold testing may be a more appropriate primary test in patients with risk factors for false-negative TST results.
接受抗肿瘤坏死因子-α治疗的患者发生活动性结核病的风险增加，支持对这些患者进行潜伏性结核病感染筛查。目前，确定潜伏性结核病感染主要（甚至完全）依赖于结核菌素皮肤试验（TST）。我们报告了 1 例接受依那西普长期治疗的银屑病患者，其 TST 结果阴性，但干扰素-γ释放试验结果阳性。通过文献复习也发现了类似病例。这些发现表明，TST 在长期接受抗肿瘤坏死因子-α治疗期间可能不可靠。对于 TST 结果可能为假阴性的有危险因素的患者，QuantiFeron-TB Gold 检测可能是更合适的初始检测。
