Abstract
Background: The interferon-γ release assay (IGRA) is a novel method for detecting previous sensitization to tuberculosis (TB). Despite having several advantages over the tuberculin skin test (TST), including higher specificity and no influence from past bacille Calmette-Guérin (BCG) exposure, there are a limited number of reports describing its application in patients with erythema induratum (EI)/nodular vasculitis (NV), which is usually but not always related to TB. Objectives: The aim of our case series was to evaluate the usefulness of the IGRA for determining a TB association in patients with EI/NV. Methods: Retrospective chart reviews were conducted on four patients diagnosed with EI/NV at our institution in whom an IGRA had been performed. Results: All four subjects had positive TST results. The IGRA was also positive and therefore supported a link with TB in two cases. One patient responded completely to anti-TB therapy, whereas the second was lost to follow-up. Both cases unrelated to TB, by virtue of negative IGRAs, demonstrated complete response to immunosuppressive therapy (methotrexate), with one individual having failed anti-TB therapy first. Conclusion: Our case series highlights the utility of the IGRA for establishing a TB association in patients with EI/NV. Although limited by a small sample size, we propose adjunctive use of this test at the time of EI/NV diagnosis, especially in the setting of previous BCG exposure, so that management can be tailored according to whether an underlying relationship with TB exists.
| Original language | English (US) |
|---|---|
| Journal | Journal of Cutaneous Medicine and Surgery |
| Volume | 17 |
| Issue number | SUPPL.1 |
| DOIs | |
| State | Published - Jul 1 2013 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Dermatology
- Surgery
Cite this
Erythema induratum : Case series illustrating the utility of the interferon-γ release assay in determining the association with tuberculosis. / Prajapati, Vimal; Steed, McKay; Grewal, Parbeer; Mahmood, Muhammad N.; Verma, Geetika; Brassard, Alain.
In: Journal of Cutaneous Medicine and Surgery, Vol. 17, No. SUPPL.1, 01.07.2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Erythema induratum
T2 - Case series illustrating the utility of the interferon-γ release assay in determining the association with tuberculosis
AU - Prajapati, Vimal
AU - Steed, McKay
AU - Grewal, Parbeer
AU - Mahmood, Muhammad N.
AU - Verma, Geetika
AU - Brassard, Alain
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Background: The interferon-γ release assay (IGRA) is a novel method for detecting previous sensitization to tuberculosis (TB). Despite having several advantages over the tuberculin skin test (TST), including higher specificity and no influence from past bacille Calmette-Guérin (BCG) exposure, there are a limited number of reports describing its application in patients with erythema induratum (EI)/nodular vasculitis (NV), which is usually but not always related to TB. Objectives: The aim of our case series was to evaluate the usefulness of the IGRA for determining a TB association in patients with EI/NV. Methods: Retrospective chart reviews were conducted on four patients diagnosed with EI/NV at our institution in whom an IGRA had been performed. Results: All four subjects had positive TST results. The IGRA was also positive and therefore supported a link with TB in two cases. One patient responded completely to anti-TB therapy, whereas the second was lost to follow-up. Both cases unrelated to TB, by virtue of negative IGRAs, demonstrated complete response to immunosuppressive therapy (methotrexate), with one individual having failed anti-TB therapy first. Conclusion: Our case series highlights the utility of the IGRA for establishing a TB association in patients with EI/NV. Although limited by a small sample size, we propose adjunctive use of this test at the time of EI/NV diagnosis, especially in the setting of previous BCG exposure, so that management can be tailored according to whether an underlying relationship with TB exists.
AB - Background: The interferon-γ release assay (IGRA) is a novel method for detecting previous sensitization to tuberculosis (TB). Despite having several advantages over the tuberculin skin test (TST), including higher specificity and no influence from past bacille Calmette-Guérin (BCG) exposure, there are a limited number of reports describing its application in patients with erythema induratum (EI)/nodular vasculitis (NV), which is usually but not always related to TB. Objectives: The aim of our case series was to evaluate the usefulness of the IGRA for determining a TB association in patients with EI/NV. Methods: Retrospective chart reviews were conducted on four patients diagnosed with EI/NV at our institution in whom an IGRA had been performed. Results: All four subjects had positive TST results. The IGRA was also positive and therefore supported a link with TB in two cases. One patient responded completely to anti-TB therapy, whereas the second was lost to follow-up. Both cases unrelated to TB, by virtue of negative IGRAs, demonstrated complete response to immunosuppressive therapy (methotrexate), with one individual having failed anti-TB therapy first. Conclusion: Our case series highlights the utility of the IGRA for establishing a TB association in patients with EI/NV. Although limited by a small sample size, we propose adjunctive use of this test at the time of EI/NV diagnosis, especially in the setting of previous BCG exposure, so that management can be tailored according to whether an underlying relationship with TB exists.
UR - http://www.scopus.com/inward/record.url?scp=84885750306&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885750306&partnerID=8YFLogxK
U2 - 10.2310/7750.2013.WOUND4
DO - 10.2310/7750.2013.WOUND4
M3 - Article
C2 - 24144256
AN - SCOPUS:84885750306
VL - 17
JO - Journal of Cutaneous Medicine and Surgery
JF - Journal of Cutaneous Medicine and Surgery
SN - 1203-4754
IS - SUPPL.1
ER -