関節リウマチの結核スクリーニングにおけるクォンティフェロンの有用性の検討

• Published in: 臨床リウマチ Vol. 21; no. 4; pp. 309 - 312
• Main Authors: 田中, 領, 清水, 克時, 四戸, 隆基, 佐藤, 正夫, 竹村, 正男
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本臨床リウマチ学会 2009; The Japanese Society for Clinical Rheumatology and Related Research
• Subjects: anti-TNF-alpha treatment; QuantiFERON TB-2G (QFT-2G) test; rheumatoid arthritis; tuberculosis
• ISSN: 0914-8760; 2189-0595
• DOI: 10.14961/cra.21.309

    The reactivation of latent tuberculosis infection is a major problem of anti-TNF-alpha treatment. Although the use of a tuberculin skin test is controversial because of the high rate of false-negative results in immunosuppressed patients, screening for tuberculosis infection is highly recommended before anti-TNF-alpha therapy is conducted. The aim of this study is to evaluate the clinical utility of the QuantiFeron TB-2G (QFT-2G) test for patients with rheumatoid arthritis before the treatment. Fifty RA patients received both tuberculin skin tests and QFT-2G blood tests. None of the50patients were suspected of having tuberculosis. Nine patients showed a reaction of more than10mm x10mm erythema in tuberculin skin tests, but these patients’ QFT-2G tests were negative. Indeterminate results were detected in QFT-2G test for 3 cases.These cases showed negative results in QFT-2G test one year later. In conclusion, it was suggested that QFT-2G test might be useful if it would be positive for the screening in RA patients for anti-TNF therapy. Both tuberculin skin test and QFT-2G test are necessary for the screening of tuberculosis infection for the time being.