False positive?

[Fishheadsoup_1]

Hi. I take Humira injections for Psoriasis and recently was found to be tested positive for Latent TB. I was instructed to stop Humira and see a Infectious Disease Doc immediately. (Appt made)

Here’s my question. I was on a 3rd round of antibiotics and steroids due to a severe sinus infection and bronchitis. One of the worst longest illnesses I’ve ever had lasting over 3 weeks.

Is it possible I tested positive because my system was loaded up with all those drugs and my body was out of whack?

Thank you

[Deniseelk]

Hi, I must say I am somewhat surprised you were not tested for all the usual infectious diseases BEFORE you started Humira. What was their reason to test you at this stage? Was it a blood test? If you think of the facts here, if they are testing for the TB bacteria that is what they are looking for. They have obviously detected the TB bacteria in your body. They would then need to carry out investigations to ensure the bacteria is not active. Usually a chest x-ray together with checking how you are generally feeling etc will determine if the bacteria is active. They must have carried out these observations to determine it is in a latent state. It is, unfortunately, not uncommon for those of us with various forms of Arthritis to suffer “ flares” and if our bodies are trying to cope with an infection too it can take longer to fight it off. In the meantime we can feel quite unwell during the fight. I suspect the latent TB bacteria had been in your body for a period of time but as it’s latent you will not be aware of it. The most important question for your Rheumatologist is should you need to eradicate the TB bacteria with antibiotics if you are to remain on Humira? I suspect their concern will be that as Humira is an immunosuppressant it puts you in a higher risk of the latent TB turning active. It is important you see your TB team for them to advise you the next stage. You are not alone.... there are a number of us ( I know of on the NRAS site) that have been through the same and have been effectively treated with TB antibiotics and now continue with our immunosuppressive drugs. I am happy to add any further input from my own personal experience but your medical team obviously know all the details of your conditions and should be happy to answer your concerns. Sounds like the next stage is to see your TB team.

[MikeMikeMike1 in reply to Deniseelk]

Hi Denise. Thank you for the reply.

Yes it was a blood test that’s required when you are on humira.

Ok get this...So I went to my internist Monday and had him redo the same test and it came back NEGATIVE!!

Great. I was super sick when the prior test was taken. I just didn’t believe the 1st test.

What I don’t understand is if the bacteria was in me why wasn’t it a week later.

Regardless I have appt with Inf. disease Doc in 2 weeks so we’ll see.

Thoughts?

[Deniseelk in reply to MikeMikeMike1]

Out of interest, you were on antibiotics being treated for another infection and sounds like an extended amount of antibiotics too. Which antibiotics were you given?

[MikeMikeMike1 in reply to Deniseelk]

I had a stubborn sinus infection and bronchitis. I was given a Z Pack then Clarithromiacin then Doxyicilin.

Was also on Steroids, Fluticasone nasal spray, musinex, Claritin, TheraFlu and chicken soup.

I typically get this sinus infection every winter but one Z Pack knocks it out. Other than that I never get sick.

[HelenC Partner TB Alert]

Hi Fishheadsoup_1,

The test will definitely have picked up TB as it specifically looks for antibodies produced by your body in response to the presence of TB bacteria.

I see you have had some useful information from Deniseelk regarding TB and immunosuppressive illness so I will not add much other than to say that the infectious disease specialist will assess whether your TB is acive or latent and go through any treatment options with you.

Please let us know the outcomes and if you need further support following your appointment you know where to find us.

Best wishes,

Helen

[MikeMikeMike1 in reply to HelenC]

Thanks Helen. Check out my reply to Denise.

Your thoughts please.

Thank you

[MikeMikeMike1]

I had to set up new name for some reason.

Now MikeMikeMike

[Hidden]

You didn't say how you were tested..... Did you have a Quantiferon gold TB test? That test is far superior to the 'skin test'. If you research Quantiferon gold blood test for TB you will see all the necessary data. Quantiferon shows latent tb in a person when the skin test is not accurate re if a person has had the BCG inoculation

[MikeMikeMike1 in reply to Hidden]

Yes it was the blood test.

[HelenC Partner TB Alert]

Hi MikeMikeMike aka Fishheadsoup,

This is good news that a second test has come back negative as this suggests your previous test result was a false positive, though equally this test may have been a false negative so it is worth discussing both possibilities with the ID specialist when you see them. False test results though rare are certainly possible and may result from biological or technical factors. The US centers for Disease Control has published a useful factsheet here cdc.gov/tb/publications/fac....

Best wishes,

Helen

[bctiguy3]

To begin, I am sorry for how long this response is. Hi, I have also been diagnosed with Latent TB and Psoriasis too. I have Psoriasis on the bottom of my right foot. I was diagnosed with the Psoriasis on October 1st of 2019. About three weeks later I started getting really sick and I turned yellow. ( Jaundiced. ) I went to the ER and didn't know there was anything wrong with me other than being sick. I then got admitted to the hospital and ended up finding out I had Acute Liver Failure not long afterwards. I was in the hospital for about four days that time then sent home and I had to go back to the ER the next week for a very painful right shoulder. I got sent home and then about ten days after that I had to go back to the ER again and this time I got admitted again to the hospital. They did a liver biopsy and couldn't find out why I had gotten Acute Liver Failure. After about four or five days I got transferred to OHSU where they had specialists that deal with Liver Failure there. I ended up staying in the hospital for two weeks that time and they were talking to me about getting on the liver transplant list. After I was in the hospital for those two weeks I was well enough to go home the day before my birthday or a little before that if I am not mistaken. Anyway, I had to go in to my doctor for testing the day after my birthday, but I was very sick again and went back to the ER after the doctor I saw had me go there to be tested instead. I got admitted yet again to OHSU and ended up being there for about another three days and got released again the day after Thanksgiving.I was put on Prednisolone and then my Psoriasis went into remission. December 31st I got admitted yet again to OHSU because of a gallbladder infection which they removed on January 1st, 2020. Middle of January I found out that my Acute Liver Failure was cured as my liver healed itself. My operation to have my gallbladder removed went very well too, so I am recovered now from the gallbladder removal surgery. However shortly after stopping the Prednisolone, my Psoriasis came back. Oh yeah, also during the testing they also apparently tested me for TB and I have Latent TB. I hope you will be a ton better very soon.