Online Resource Information
Diagnosis of Latent Tuberculosis Infection with T-SPOT®.TB in a Predominantly Immigrant Population with
Rheumatologic Disorders
Patricio Escalante1; Kirstin J. Kooda2; Rizwana Khan3; San San Aye4; Stratos Christianakis5; Daniel G. Arkfeld5;
Glenn R. Ehresmann5; Jens J. Kort6; Brenda E. Jones7
1
Division of Pulmonary and Critical Care Medicine and Mayo Clinic Center for Tuberculosis, Mayo Clinic,
Rochester, MN, USA;
2
Department of Pharmacy Services, Mayo Clinic, Rochester, MN, USA;
3
Pulmonary and Critical Care Medicine, Lung and Asthma Center of Central Washington, Yakima, WA, USA;
4
Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;
5
Division of Rheumatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;
6
AbbVie Inc., North Chicago, IL, USA;
7
Division of Infectious Disease, Keck School of Medicine, University of Southern California, Los Angeles, CA,
USA
Corresponding Author:
Patricio Escalante, MD, MSc, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW,
Rochester, MN 55905, USA; E-mail: escalante.patricio@mayo.edu
Online Resource Table —Risk factors for TB infectiona and for TB disease progression from infection (i.e. immunosuppressive drugs)b
in Patients with discordant TST and TSPOT results
Country of
Birtha
Close
TB
Contacta
Unk
No
No
No
No
No
No
No
No
No
Rheumatologic
Diagnosis
Rheumatologic
Medicationb
TST
Results
TST
Induration
Mexico
Mexico
USA
Mexico
Mexico
Mexico
Mexico
Bolivia
Guatemala
Guatemala
Years
in TB
Areaa
48
24
n/a
21
27
33
20
50
21
32
TSPOT Conditions
Nil
ESAT-6 CFP-10
TSPOT
Results
RA
RA
AS
RA
RA
RA
RA
RA
RA
RA
TST+
TST(c)
TST+
TST(c)
TST(c)
TST+
TST+
TST+
TST+
TST+
25
20
35
19
10
17
+
+
18
15
0
2
8
0
0
0
0
3
0
0
0
1
6
0
0
0
0
1
0
2
1
0
9
0
0
0
1
1
0
0
Neg
Neg
Neg
Neg
Neg
Neg
Neg
Neg
Neg
Neg
El Salvador
Mexico
Mexico
Mexico
USA
21
37
34
n/a
n/a
No
Yes
No
No
No
RA
RA
RA
RA/AS
RA
TSTTSTTSTTSTTST-
-
1
0
1
0
0
0
4
1
0
3
12
20
9
6
6
Pos
Pos
Pos
Pos
Pos
Mexico
26
No
RA
etanercept/PRED
MTX/HCLQ
adalimumab
MTX/HCLQ
Pre-MTX
PRED
MTX/infliximab
PRED/leflunomide
MTX
SSZ/Preadalimumab
Pre-etanercept
MTX
PRED/MTX
MTX
rituximab/PRED/
azathioprine
MTX/HCLQ
TST+(c)
19
>10
20
20
Indet.c
Mexico
25
No
RA
PRED/HCLQ/MMF
TST+(c)
20
0
0
0
Indet.d
Mexico
18
Unk
etanercept
TST-
-
>10
20
20
Indet.c
Mexico
33
No
Psoriatic
arthritis
Psoriatic
arthritis
RA
AS
SLE
Unk
TST-
-
1
1
0
Indet.d
Indet.d
Indet.d
Insuff.
cells e
USA
n/a
Unk
SLE
PRED/azathioprine/
TSTInsuff.
HCLQ
cells e
Abbreviations: TB, tuberculosis; TSPOT, T-SPOT®.TB; TST, tuberculin skin test; TST(c), TST conversion; ESAT-6/CFP-10, TSPOT antigens;
Neg(-), negative; Pos(+), positive; Nil, (-) control; Unk, unknown; n/a, not available; HCLQ, Hydroxychloroquine; MTX, methotrexate; MMF,
Mexico
USA
El Salvador
12
n/a
22
No
No
No
PRED/MTX/HCLQ
PRED
azathioprine
TSTTSTTST-
-
1
0
-
2
1
-
1
0
-
mycophenolate mofetil; PRED, prednisone; SSZ, sulfasalazine; Pre-, prior to; RA, rheumatoid arthritis; AS, ankylosing spondylitis; SLE, systemic
lupus erythematosus; Indet, indeterminate TSPOT results; Insuff. cells, insufficient number of cells obtained for TSPOT test
a
Risk factors for TB infection.
b
Includes immunosuppressive drugs that increase risk for TB disease progression from infection.
c
Indeterminate TSPOT results associated with high spot forming units (sfu) counted in negative control well and high background noted in all wells.
d
Indeterminate TSPOT results associated with low sfu counted in positive control well and high background in all wells.
e
TSPOT results were not obtained due to insufficient number of peripheral blood monocyte cells obtained after standard FICOLL-PLAQUE™ cell
separation procedure.