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06-10-2017, 10:24 PM   #1
amor1218
 
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Lab work results

Hey everyone. Does anyone have experience with an indeterminate Quantiferon gold TB test? What is the next step...to repeat the test?

Also, does anyone know what these results mean?
Anisocytosis: Mild
Hypochromia: Mild
Microcytes: Mild
Atypical Lymphocytes: Seen

Thanks in advance!
06-11-2017, 03:34 PM   #2
Maya142
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I'm going to tag my little penguin, since she probably knows more.

Has your kiddo had a PPD? And a chest x-ray? That would probably be the next step.

What meds is your child on?
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Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
06-11-2017, 03:38 PM   #3
amor1218
 
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I'm going to tag my little penguin, since she probably knows more.

Has your kiddo had a PPD? And a chest x-ray? That would probably be the next step.

What meds is your child on?
He hasn't had had any additional testing. I just got these lab results this week and was surprised about the TB one. He takes 2 Apriso a day but that just started this week. He was on 1 per day.
06-11-2017, 03:46 PM   #4
Maya142
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I think the Quantiferon test can be unreliable, which is why PPDs are often used instead or with it. I would guess if his PPD is ok and chest x-ray is fine, he probably won't need treatment.

My girls had the opposite problem after receiving the BCG vaccination (for TB) when we were abroad - their PPDs will always be positive, so we HAVE to use the blood test.

We consulted to infectious disease doctors, who did chest x-rays and the blood test and determined it was a false positive. Both girls were allowed to start biologics and have been on them for years without problems (and have negative blood tests and chest x-rays in that time).

So I would not panic yet, just talk to your GI.

Are they preparing to put him on a biologic? If so it might be worth consulting infectious diseases.
06-11-2017, 03:48 PM   #5
Maya142
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What kind of results do you get with the QuantiFERON®-TB Gold test?
Most times, the QuantiFERON®-TB Gold test gives a positive or negative result. The positive result means you are infected with TB, and the negative result usually means you are not infected with TB. Sometimes, the result will not be either positive or negative. In this case, the result is called “indeterminate.” An indeterminate result may mean that something went wrong with part of the blood testing process or it may mean that your white blood cells are not working well due to a weakened immune system. If your result comes out as indeterminate, the test should be repeated, and if the second result is also indeterminate, you will need to talk to your doctor about what to do next.
Looks like they will have do another Quantiferon test too.
06-11-2017, 03:50 PM   #6
amor1218
 
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I think the Quantiferon test can be unreliable, which is why PPDs are often used instead or with it. I would guess if his PPD is ok and chest x-ray is fine, he probably won't need treatment.

My girls had the opposite problem after receiving the BCG vaccination (for TB) when we were abroad - their PPDs will always be positive, so we HAVE to use the blood test.

We consulted to infectious disease doctors, who did chest x-rays and the blood test and determined it was a false positive. Both girls were allowed to start biologics and have been on them for years without problems (and have negative blood tests and chest x-rays in that time).

So I would not panic yet, just talk to your GI.

Are they preparing to put him on a biologic? If so it might be worth consulting infectious diseases.
I'll be sure to ask him if I don't hear from him this week. He's usually good about emailing after test results come down. His doctor hasn't mentioned a biologic yet...this was part of his initial diagnosis blood work that his doctor wanted to run. I hope it's a test error or something.
06-11-2017, 04:11 PM   #7
my little penguin
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Blood test is more reliable than the ppd
When someone is immunosuppressed they may not mount a defense against tb ppd
So you would get a false negative

The blood test has a postive control
And a negative control
So it shows if your body is too suppressed to even react
Most only do ppd because ppd is cheaper

Not more accurate

It is not recommended to get a ppd then blood test
Since the ppd can "boost" the response in the blood test basically giving a false positive
Numerous ppd over time can also cause a false postive

I would assume they would just do another blood test

Good luck
But assume they would want a chest X-ray as well
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06-11-2017, 04:17 PM   #8
Maya142
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MLP definitely knows more than I do about this ! I'm sure your GI will let you know what the next steps are soon. Hang in there!!
06-11-2017, 05:29 PM   #9
Optimistic
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They may order a different blood test, the t-spot. It is more expensive and laborious for lab than quantiferon, but it may be best option for patients who may have compromised immune systems. Some hospitals now use t-spot for enployees.

My ds had false positives with skin tests.
06-11-2017, 08:15 PM   #10
Trysha
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The terms anisocytosis,hypochromia and microcytes could all relate to an anemia.
Atypical lymphocytes may indicate a viral infection among other things
Your doctor is the best person to discuss these results with you and apply any necessary treatment if needed.
Feel better soon.
Hugs and best wishes
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