JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Latent tuberculosis infection in psoriasis patients
Abstract
Aims: Psoriasis is a chronic, inflammatory, and life-long skin disease. Patients may need to change the treatment regimen by time due to the course of the disease. According to the guidelines, patients should be screened for latent tuberculosis infection (LTBI) before starting treatment with biological agents. We aimed to evaluate the associations between positive interferon-gamma release assay (IGRA) tests, the chest CT findings and inflammatory blood markers of the psoriasis patients who have undergone screening for LTBI before starting systemic treatment with biological agents or conventional options.
Methods: The electronic medical records, Chest CT reports and blood tests of 123 consecutive patients with a diagnosis of psoriasis who were candidates for systemic treatment (methotrexate, cyclosporin and biological agents) and screened for LTBI were examined.
Results: The mean age of the patients was 49.24 and 64 (52%) of them were males. 37(30%) had a family history of tuberculosis 103(83%) of them had BCG vaccination scars. 59% had radiological features on their Chest CT scans. 28% of the patients had positive Quantiferon test results. When compared to the Quantiferon negative group, there was no difference between the two groups according to demographic characteristics, comorbidities, family history of tuberculosis, BCG vaccination status, smoking habits, occupation, and qualification details (p>0.05). The values of WBC, neutrophils, lymphocyte, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, systemic inflammation index and erythrocyte sedimentation rates were found statistically higher in the patients with positive Quantiferon test (p<0.05).
Conclusion: The patients with psoriasis requiring systemic treatment and having positive IGRA test results have increased levels of inflammation. Psoriasis and LTBI might have a synergistic action in the inflammatory response which necessitates further studies to find out the associations between these two entities.

Keywords : Latent TB, psoriasis, quantiferon, lung, chest CT

Download Article


1. Rend&oacute;n A, Sch&auml;kel K. Psoriasis pathogenesis and treatment. Int JMol Sci. 2019;20(6):1475. doi.org/10.3390/ijms20061475
2. Brajac I, Gruber F. History of psoriasis. In InTech eBooks. 2012.doi.org/10.5772/27640
3. Smith C, Jabbar-Lopez ZK, Yiu ZZN, et al. British Association ofDermatologists guidelines for biologic therapy for psoriasis 2017.Br J Dermatol. 2017;177(3):628-636. doi.org/10.1111/bjd.15665
4. Herzog H. History of tuberculosis. Respiration, 1998;65(1):5-15.doi.org/10.1159/000029220
5. Programme, G. T. Global tuberculosis report 2021. 2021. https://www.who.int/publications/i/item/9789240037021
6. T&uuml;rkiye&rsquo;de Verem Savaşı 2020 Raporu. https://hsgm.saglik.gov.tr/tr/tuberkuloz-haberler/turkiye-deverem-savasi.html. Accessdate:10.03.21
7. Salgame P, Geadas C, Collins LF, Jones-L&oacute;pez EC, Ellner JJ. Latenttuberculosis infection - revisiting and revising concepts. Tuberculosis.2015;95(4):373-384. doi.org/10.1016/j.tube.2015.04.003
8. Stop TB Field guide 6: Using Contact Investigation to ImproveTB Case Detection, (2018). https://stoptbstrategicinitiative.org/elearning/wpcontent/uploads/2019/04/STBFG_06.pdf Accessdate: 25.10.2019
9. Tuberculosis. (2023, April 21). Available at: https://www.who.int/features/qa/08/en/
10. Barcellini L, Borroni E, Brown J, et al. First independentevaluation of QuantiFERON-TB Plus performance. Eur Respir J.2016;47(5);1587-1590. doi.org/10.1183/13993003.02033-2015
11. Kodali N, Blanchard I, Kunamneni S, Lebwohl M. Currentmanagement of generalized pustular psoriasis. Experim Dermatol.2023;32(8):1204-1218. https://doi.org/10.1111/exd.14765
12. Jonas DE, Riley S, Lee LC, et al. Screening for latent tuberculosisinfection in adults. JAMA. 2023;329(17):1495. doi.org/10.1001/jama.2023.3954
13. Feng P, Horne D, Wortham JM, Katz D. Trends in tuberculosisclinicians&rsquo; adoption of short-course regimens for latenttuberculosis infection. J Clin Tuberc Other Mycobact Dis.2023;33:100382. doi.org/10.1016/j.jctube.2023.100382
14. Mangione CM, Barry MJ, Nicholson WK, et al. Screening forlatent tuberculosis infection in adults. JAMA. 2023:329(17):1487.doi.org/10.1001/jama.2023.4899
15. Ghesani N, Patrawalla A, Lardizabal A, Salgame P, FennellyKP. Increased cellular activity in thoracic lymph nodes in earlyhuman latent tuberculosis infection. Am J Respir Crit Care Med.2014;189(6):748-750. doi.org/10.1164/rccm.201311-1976le
16. Wallis RS, Kim P, Cole ST, et al. (2013). Tuberculosis biomarkersdiscovery: developments, needs, and challenges. Lancet Infect Dis.2013;13(4):362-372. doi.org/10.1016/s1473-3099(13)70034-3
17. Akinshipe BO, Yusuf EO, Ehiaghe FA, Egunjobi TO, Yusuf OA.Elevated high-sensitivity C-reactive protein among apparentlyhealthy adults with concomitant prediabetes and latenttuberculosis infection in Nigeria. Int J Res Med Sci. 2021;9(2):338.doi.org/10.18203/2320-6012.ijrms20210407
18. Katakura S, Kobayashi N, Hashimoto H, et al. Identification of anovel biomarker based on lymphocyte count, albumin level, andTBAg/PHA ratio for differentiation between active and latenttuberculosis infection in Japan. Tuberculosis. 2020;125:101992.doi.org/10.1016/j.tube.2020.101992
19. Moore N, Maher M, Murphy G, Maher MC, O&rsquo;Connor OJ,McEntee MF. CT in the detection of latent tuberculosis: asystematic review. Clin Radiol. 2023;78(8);p568-575.
20. Polat M, Buğdaycı G, Kaya H, Oğuzman H. Evaluation ofneutrophil-to-lymphocyte ratio and platelet-to-lymphocyteratio in Turkish patients with chronic plaque psoriasis.Acta Dermatovenerologica Alpina, Pannonica Et Adriatica.2017;26(4):97-101. doi.org/10.15570/actaapa.2017.28
21. Lagunas-Alvarado M, Mijangos-Huesca FJ, Ter&aacute;n-Gonz&aacute;lez J&Oacute;,et al. Systemic immune inflammatory index in sepsis. &iacute;ndice deinmunidad-inflamaci&oacute;n sist&eacute;mica en sepsis. Med Interna M&eacute;xico,2017;33(3):303-309.
22. Yorulmaz A, Hayran Y, Akpınar &Uuml;, Yal&ccedil;ın B. Systemic Immune-Inflammation Index (SII) predicts increased severity in psoriasisand psoriatic arthritis. Curr Health Sci J. 2020;46(4):352-357. doi.org/10.12865/chsj.46.04.05
23. Rota DD, Tanacan E. The utility of systemic-immune inflammationindex for predicting the disease activation in patients withpsoriasis. Int J Clin Pract. 2021;75(6):e14101 doi.org/10.1111/ijcp.14101
Article available in :
Volume 7, Issue 1, 2024
Page : 47-52
https://doi.org/10.32322/jhsm.1357532
Article Information
Received : 08 Eyl 2023
Accepted : 03 Ara 2023
Published : 15 Oca 2024
Corresponding Author :

Müfide Arzu Özkarafakılı: Department of Chest Diseases, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, İstanbul, Turkiye

[email protected]
Citation : Özkarafakılı MA, Sivaz O, Kıvanç Altunay İ. Latent tuberculosis infection in psoriasis patients. J Health Sci Med. 2024;7(1):47-52.

Read: 118
Cited: 0
Download : 104
_Footer