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BioMed Research International
Volume 2014, Article ID 291031, 8 pages
http://dx.doi.org/10.1155/2014/291031
Clinical Study

Diagnosis of Latent Tuberculosis in Patients with Systemic Lupus Erythematosus: T.SPOT.TB versus Tuberculin Skin Test

1Department of Internal Medicine, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas No. 2, 18004 Granada, Spain
2Department of Infectious Diseases, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas No. 2, 18004 Granada, Spain
3Department of Clinical Analysis, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas No. 2, 18004 Granada, Spain

Received 7 February 2014; Revised 8 April 2014; Accepted 9 April 2014; Published 28 May 2014

Academic Editor: Juan-Manuel Anaya

Copyright © 2014 Maria Del Mar Arenas Miras et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Early studies in patients with systemic lupus erythematosus (SLE) reported increased incidence of tuberculosis. The tuberculin skin test (TST) is the technique of choice to detect latent tuberculosis infection (LTBI) but has several limitations. Objectives. We compared TST and the newer T.SPOT.TB test to diagnose LTBI in SLE patients. Methods. In this observational cohort study conducted between August 2009 and February 2012, we recruited 92 patients from those attending the SLE clinic of our university hospital. Data recorded were epidemiological and sociodemographic characteristics. Laboratory analyses included TST and T.SPOT.TB tests. Results. Of the patients studied, 92% were women with an average age of 42.7 years. Overall, the degree of correlation between the two tests was low (Kappa index = 0.324) but was better in patients not receiving corticosteroids (CTC)/immunosuppressive (IS) therapy (Kappa = 0.436) and in those receiving hydroxychloroquine (Kappa = 0.473). While TST results were adversely affected by those receiving CTC and/or IS drugs ( ), the T.SPOT.TB results were not. Conclusion. Although the TST test remains a useful tool for diagnosing LTBI in SLE patients, the T.SPOT.TB test is perhaps better employed when the patient is receiving CTC and/or IS drugs.