As I wrote last night on the Say It Here thread, I got lab results that show my range way above normal for TB1 and TB2 NIL and an abnormal reading for the Quantiferon TB Gold Plus. I’m asymptomatic so it could be a bad reading or latent. I’m not that concerned, but dh is freaking out a bit so y’all tell me, is there something I should be doing? Should I be more concerned than I am?
This bloodwork is requested by my dermatologist as a monitoring thing because he prescribes an immunosuppressant, and this particular test was in preparation for tomorrow morning’s appointment. This is the first time I’ve had a positive result. I called his office to make sure that they got the results and his nurse called back to say they did this afternoon (Can we talk about everyone having results of testing before the doctor? Ugh). I asked her to give me an idea of what next steps would be, and she said that he likely would suggest a re-test in a month.
Is that sufficient? Anyone have experience? Should I insist on a skin test? TIA
Not sure what kind of test it was, but S tested positive for TB several months ago. He was very upset because it prevented him from getting medication he needs for another condition.
He retested about a month ago, and is now testing negative. I would retest in a few months.
I believe the next step is a chest x-ray, call your primary and let them know. You will not be able to start the biological since those suppress the part of the immune system that keeps TB in check. Good luck
I know 2 people who always test positive for tb and it’s pain because they have jobs that require tb testing. They have to get X-rays before being cleared. One had to get X-rays throughout her pregnancies
I had a GOLD blood test for TB 3 times at 3 different med centers. Once it was positive and the other 2 times it was negative, including the most recent tests. My docs aren’t concerned. My x-rays and CT scans all show no evidence of TB—former or current. Tests can be wrong.
I understand a chest X-ray if I was symptomatic, but I don’t see where that’s called for in this case.
I don’t love this dermatologist, who over time seems to have shifted most of his business to cosmetic procedures. But my only reason to see him is to update the RX for the immunosuppressant, and he’s always handled that well so I stuck with him. Hope I don’t regret that.
The skin test is absolutely unreliable. All it can show is presence of antibodies against TB, but it doesn’t tell if that is due to immunization (BCG), some past exposure to TB, or latent infection. The next step would likely be Xray as mentioned by others, but if you’re not having any symptoms, you’re in the clear to travel.
My DD tested positive for TB for more than a year…and it came up on her physicals for summer programs. In each case, she had a chest X-ray, and got a doctors note saying she was ok to go. I think she had that tine test first both times, then a second more supposedly accurate test, and then the chest X-rays. She never had any symptoms, and at that point had not travelled out of the country except to go to London with us.
Then poof…she stopped testing positive.
It was quite the shock when she got that positive test. I remember looking at her arm and seeing the red raised bump…didn’t even wait for the doctor appt to read the results. Took her asap. Even the doctor was surprised.
I wish I could remember more about this, but it was before she graduated from high school 20 years ago!
The skin test had NOT been reliable for me as far back as I can remember. I was exposed to TB and my mom and a sister had to take prolonged antibiotics because they had tested positive for it (but asymptomatic).
My H caught TB in med school. Whole family tested. D positive, S and I negative. H was on several drugs for a year. He had serious cavitations in his lungs though asymptomatic ( tired but what med student isn’t?) D’s X-ray was clear. She was on one drug for I think six months. She’ll always need an X-ray if tb testing is mandated because she’ll always test positive. But treatment before active disease means she is effectively vaccinated. S and I took several months of drug prophylactically . Because H’s lungs were so scarred, we really worried in the early days of covid.
It was a scary time for the family when it first happened, especially because it was the eighties and people were already freaking out about kids with AIDS. Luckily D’s friends parents were thoughtful people. I think people are more informed now .
I had always tested positive on the tine test but they would then do a needle test in the same area and I would never react to that test. I wonder if it has anything to do with the fact I have contact dermatitis and react to a lot of things.
The role of the chest x ray is to look for changes associated with asymptomatic tb. You could have active disease without symptoms. A positive tb test and symptoms is treated in isolation in the hospital.
When S2 was 3, he tested positive with the tine test. The pediatrician’s office didn’t believe the result, so they did the test again – same result. He wound up taking isoniazid in liquid form for six months. It was a royal pain in the patootie to get a three-year-old to take three teaspoons of isoniazid every day for six months. We called it the “one-two-three medicine.”
He has had some biologic infusions due to an autoimmune disease. I have no idea if he was tested for TB beforehand.
I don’t know if it’s changed, but H never had to stay in hospital. He did have to isolate at home for a couple weeks, which delayed the start of his residency. (TB was found during routine checkup for the residency).
My daughters both had blood tests (they’re both in health care environments and it was a requirement for employment). #2D who is in a clinic office says they still do the skin tests, but the blood test is much more accurate. The issue with them is that they require you to go into the clinic 48-72 hours after the test.
Because of where my family business was located, we all had annual tine tests. My oldest sister showed exposure each year, so she wasn’t really allowed to be there. That was decades ago.
Federal law that they have to post the results as soon as available, and sometimes it hits the portals (MyChart, Navigating care, your health system’s version) before the doctors even have time to review. I almost always find my before the doctor can review.
