Katsenos Stamatis, Nikolopoulou Melita, Tsiouri Georgia, Bassukas Ioannis D, Constantopoulos Stavros H
Department of Pneumonology, University Hospital of Ioannina, Ioannina, Greece.
Open Respir Med J. 2011;5:59-60. doi: 10.2174/1874306401105010059. Epub 2011 Jun 24.
It is well-established that tumour necrosis factor (TNF)-α-antagonist regimens are advisable for the control of moderate to severe psoriasis; however the application of these agents is associated with increased risk of TB reactivation. Screening for latent tuberculosis infection (LTBI) is indispensable prior to treatment inception in order to diminish the risk of active TB. Although tuberculin skin test (TST) still represents a useful tool for LTBI detection, it is difficult to be performed and read in patients with extensive psoriatic lesions. In this paper, we report the case of a 65-year-old male with severe psoriasis, who was evaluated by an interferon-gamma release assay (IGRA) for LTBI diagnosis prior to anti-TNF-α therapy. Furthermore, the physiological aspects of interferon-gamma release assays are discussed emphasizing the value of these novel immunodiagnostic tests (IGRAs) for presumable LTBI in all patients with extensive skin disorders.
众所周知，肿瘤坏死因子（TNF）-α拮抗剂方案对于控制中度至重度银屑病是可取的；然而，应用这些药物会增加结核病重新激活的风险。在开始治疗前进行潜伏性结核感染（LTBI）筛查对于降低活动性结核病的风险是必不可少的。尽管结核菌素皮肤试验（TST）仍然是检测LTBI的有用工具，但对于有广泛银屑病皮损的患者来说，该试验难以实施和判读。在本文中，我们报告了一例65岁重度银屑病男性患者的病例，该患者在接受抗TNF-α治疗前通过干扰素-γ释放试验（IGRA）进行LTBI诊断评估。此外，还讨论了干扰素-γ释放试验的生理方面，强调了这些新型免疫诊断试验（IGRAs）对于所有有广泛皮肤疾病的疑似LTBI患者的价值。
