Prevalence of positive ppd in a cohort of rheumatoid arthritis patients

Maria Natalia Tamborenea1, Guillermo Tate, Eduardo Mysler

  • 1Department of Rheumatology, Organización Médica de Investigación, Uruguay, 725 PB, C1015ABO, Ciudad Autónoma de Buenos Aires, Argentina. nataliatamborenea@hotmail.com

Insights

In rheumatoid arthritis patients, high-dose steroids predicted negative tuberculin skin tests (TST), while methotrexate use correlated with TST anergy. This study investigated TST prevalence and its associations in RA patients.

Area of Science:

  • Immunology
  • Rheumatology
  • Infectious Disease Epidemiology

Background:

  • Rheumatoid arthritis (RA) patients often have altered immune responses.
  • Tuberculin skin test (TST) is used to screen for latent tuberculosis infection (LTBI).
  • Factors influencing TST results in RA patients require further investigation.

Purpose of the Study:

  • To determine the prevalence of positive and anergic TST reactions in a cohort of RA patients.
  • To assess the association between TST results and clinical/treatment variables in RA.
  • To identify predictors of TST positivity, negativity, and anergy in RA.

Main Methods:

  • A cohort of 105 RA patients underwent TST using the Mantoux method.
  • Positive TST was defined as induration ≥5 mm; anergy was defined as 0 mm induration.
  • Statistical analysis, including multivariable modeling, was used to assess associations.

Main Results:

  • The prevalence of positive TST was 12.4%, negative TST was 87.6%, and TST anergy was 69.5%.
  • Higher steroid dosages were independently associated with negative TST results (OR 0.72).
  • Higher methotrexate dosages were independently associated with TST anergy (OR 1.14).

Conclusions:

  • The prevalence of positive TST in this RA cohort was relatively low.
  • High-dose corticosteroids are a significant predictor of negative TST in RA patients.
  • Methotrexate treatment is associated with TST anergy in RA patients, suggesting an impact on cellular immunity.

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