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01-23-2015, 05:38 AM   #1
CDJ
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Quantiferon test

Josh's quantiferon test has come back indeterminate which means they need to repeat the test before they will start Infliximab. We had been building ourselves up to him starting Infliximab and it's annoying that he will need to have the test done again first, it just means more delay.

They have said that if the next one comes back the same they will have to treat him with prophylaxis TB meds along side the Infliximab. Does anyone know what this is and what it will do?
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diagnosed 29/10/2009

Taken off azathioprine Jan 2011 due to needle phobia
carried on with just pentasa until March 2013

6 weeks Modulen Dec 12 / Jan 13

Finally overcame needle phobia after 3 very long years due to getting right help.

Currently on
125mg Azathioprine
3000mg Pentasa
20g Omeprazole
20mg Buscopan
5mg Prednisolone
Isoniazid
Pyridoxine
600mg ferrous gluconate
250mg zinc
Started Infliximab 18/03/15
01-23-2015, 07:21 AM   #2
my little penguin
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Has he had a chest xray as well ??
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01-23-2015, 07:27 AM   #3
malorymug
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Hi. I just had this happen last week. We solved it by doing the old skin test method (PPD or mantoux). And we also had to get a ct scan of his lungs because the xrays found "dense nodules". It didn't change our infusion date (but I did run around like crazy to get these tests done in time).

Because the skin test didn't react and the ct scan didn't see the tb "halos" we were clear to start Infliximab.

Dusty has a great explanation as to why the Quantiferon test comes back indeterminate for crohn's patients. If I can paraphrase, if the CRP is high, the Quantiferon will come back indeterminate.

This begs the questions, why use the Quantiferon test when you know the CRP is high.

Wishing you luck in getting this sorted.
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Mom to: 15 year old boy
Crohn's in stomach, small intestine, large intestine, and perianal disease
Diagnosed April 2014, at age 13

Currently taking:
Remicade 10mg/kg every 6 wks
Methotrexate 7.5 mg/wk
Cipro
Augmentin
Miralax

previous meds:
6mp 50mg
Flagyl
Cipro
Prednisone 30 mg
01-23-2015, 02:03 PM   #4
CDJ
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Thank you for the replies. The CRP makes sense as Josh's inflammation levels are really high at the moment, one of the reasons they are going to start Infliximab. It does make you wonder why they do the Quantiferon test if the CRP is going to give false readings.
He had a repeat Quantiferon test done today, so we shall see what that result brings. I have been told that if that comes back indeterminate again then they will treat him with prophylaxis meds to run along side his infliximab. Not sure what this is either. I am new to all these ones. I thought I had crohns sussed until now

Josh hasn't had a chest X ray done yet, we have been told that he can get this done the same day that he starts the Infliximab.
01-23-2015, 09:47 PM   #5
araceli
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My understanding is that TB medicine should be given prior to infliximab not along with. If TB is suspected why lower the immune system? Another question I will have is, if the chest xray is done the same day, will you know if the result are negative before infusion? I really hope you can sort this out before infusion day.
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Mom/ Girl 19
dx 2011 crohn's in terminal ileum, peri-anal
Prior Meds Asacol, Prednisone, nexium
Current meds.
Remicade since Nov. 2012
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01-25-2015, 06:00 AM   #6
DustyKat
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I think its a difficult situation when these sort of tests need to be done. Chances are you flaring when the decision needs to be made to go onto biologics and a TB test is a prerequisite for doing so, then you are caught in that catch 22.

Matt was to have his Quantiferon Gold done when he was diagnosed 4 years ago. So he too would have had a high CRP. As it was things went pear shaped very quickly and it was never done. He only ended up having it done 6 months ago just to have it on record along with Hepatitis A,B,C and Varicella.

Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with REMICADE and during treatment with REMICADE.

Even if your TB test is negative, your doctor should carefully monitor you for TB infections while you are taking REMICADE. Patients who had a negative TB skin test before receiving REMICADE have developed active TB.

http://www.remicade.com/shared/produ...tion-guide.pdf
Dusty. xxx
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01-25-2015, 02:52 PM   #7
crohnsinct
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...and just FYI, you are supposed to do the skin test yearly.
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Daughter O dx 2/1/12 at age 12
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Remicade
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Daughter T dx 1/2/15 at age 11
Vitaligo, Precoscious puberty & Crohns
Methotrexate (15mg weekly oral)
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Previously used: Mtx injections
01-25-2015, 03:13 PM   #8
my little penguin
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Yep
Ds has a test every year
01-25-2015, 06:28 PM   #9
malorymug
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Dang! Adding it to the list.
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