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Indeterminate TB test?

My doctor wants to start me on remicade for a fistula. My crohns is pretty much controlled now, but I recently had the abscess drained and a seton put in and I'm having lots of drainage and apparently the fistula is pretty bad. They want to start remicade tomorrow.

I've had two TB tests and both have come back indeterminate. I have no known exposure to TB. I have had a clear chest X-ray. The doctor is theorizing that the prednisone I'm on could be skewing the test. He wants to go ahead with the infusion and just closely monitor me. I'm nervous though- I know it's super risky to have remicade and TB.

Anyone else have an indeterminate test? What did you do?
 
I've also heard that prednisone can do that. My GI in Seattle did a second test for TB, although this one was a blood test, and because I was on both prednisone and remicade the test came back indeterminate. I retook it twice and it happened both times. I didn't have TB and I was just fine.
 

nogutsnoglory

Moderator
I have had an indeterminate TB test and it means you need a PPD instead of a blood test to rule it out.

They inject a substance into your arm and within 48 hours they measure the bump to see if you are positive or not. They should do this test before you begin Remicade.
 
I had a regular TB test and a PPD test and they both came back indeterminate. I had been on a high dose of Prednisone for 2 months, which I was told if you're on 20mg or more it can have your TB test come back indeterminate. I had to meet with an infectious disease doctor who determined after many questions and a physical exam that I did not have TB, so that I was able to go forward with Remicade. It also helped too, that I work in education and I have had several TB tests in the past that all came back negative. I'm due for my third Remicade treatment in less than 2 weeks and I've been fine. The infectious disease doctor that examined me, just wants me to go back in for a TB test 2 weeks after being off Prednisone.
 
It is very important to check for TB before and during Remicade treatment, but it is also before prednisone treatment. I think there are 4 tests for TB, the PPD, blood test, chest Xray and the stool exam for evidence of a intestinal parasites, especially strongyloides, since there is also intestinal TB. I am not a Doc, just what I have read.
 
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