Assessing his panic

A study of Indian patients with inflammatory rheumatic diseases looked at the performance of 4 diagnostics prior to treatment with a tumor necrosis factor-alpha (TNF-alpha) inhibitor. Those 4 diagnostics were the TB skin test, QuantiFERON, standard chest Xray and a CT scan.

One patient, who had a negative result to all 4 tests, later developed active TB after treatment with the inhibitor.

This result caused a stir in Mexico where rheumatologists observed that

it could be reasonable to receive therapy for latent TB before taking TNF-α inhibitor agents, independent of the TST results

There must be more to this story