Ayaz, N Aktay

Bakkaloglu, A

Besbas, N

Bilginer, Y

Demirkaya, E

Ozcelik, U

Ozen, S

Çobanoglu, N

English

PubMed

N Aktay Ayaz

E Demirkaya

N Çobanoglu

Y Bilginer

N Besbas

U Ozcelik

A Bakkaloglu

S Ozen

Crossref

A safe protocol for tuberculin test assessment in a country where BCG vaccination is mandatory

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BioMed Central
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Pediatric Rheumatology
Open AccessPoster presentation
A safe protocol for tuberculin test assessment in a country where 
BCG vaccination is mandatory
N Aktay Ayaz*, E Demirkaya, N Çobanoglu, Y Bilginer, N Besbas, U Ozcelik, 
A Bakkaloglu and S Ozen
Address: Hacettepe University Medical Faculty, Ankara, Turkey
* Corresponding author    
Background
Tumor necrosing factor antagonists are being widely used
for the treatment of juvenile idiopathic arthritis (JIA). One
concern during the treatment with anti-TNF agents is the
risk of activating tuberculosis (Tbc).
Aim
We evaluated JIA patients who received anti-TNF treat-
ment, from an eastern Mediterranean country with mod-
erate tuberculosis frequency (official notification rate is
27/100 000).
Materials and methods
Thirty-seven JIA patients under anti-TNF treatment were
enrolled to the study. Chest-X rays, purified protein deriv-
ative (PPD) tests, clinical histories and physical examina-
tions were reviewed retrospectively. If PPD was above 10
mm in a patient with one BCG vaccination, family screen-
ing, cultures and if needed thorax computerized tomogra-
phy were obtained and isoniazid prophylaxis was started
for a period of 9 months. All were re-evaluated within 3
month intervals.
Results
Fifteen were females, 22 were males. Mean age was 14.2 ±
5.3 years. Mean follow up after initiation of etanercept
was 12.7 ± 10.9 months. Seven patients had an initial PPD
score above 10 mm. All received concomitant isoniazid
treatment. Except one patient with a very severe course of
systemic JIA under aggressive immunosuppressive ther-
apy, all had normal examinations and X-rays. This one
patient had a consolidation and cavitation at his right
superioposterior lung zones. He is on antituberculosis
treatment now without any overt clinical features of Tbc.
Conclusion
With proper initial evaluation anti-TNF treatment is safe
even in countries where Tbc is moderate frequency. A 9-
month isoniasid treatment is suggested for children with
a ppd of >10 mm.
from 15th Paediatric Rheumatology European Society (PreS) Congress
London, UK. 14–17 September 2008
Published: 15 September 2008
Pediatric Rheumatology 2008, 6(Suppl 1):P49 doi:10.1186/1546-0096-6-S1-P49
<supplement> <title> <p>15<sup>th </sup>Paediatric Rheumatology European Society (PreS) Congress</p> </title> <editor>Wietse Kuis, Patricia Woo, Angelo Ravelli, Hermann Girschick, Michaël Hofer, Johannes Roth, Rotraud K Saurenmann, Alberto Martini, Pavla Dolezova, Janjaap van der Net, Pierre Quartier, Lucy Wedderburn and Jan Scott</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/PDF/1546-0096-6-S1-full.pdf">here</a>.</note> </supplement>
This abstract is available from: http://www.ped-rheum.com/content/6/S1/P49
© 2008 Ayaz et al; licensee BioMed Central Ltd. 


Ayaz N Aktay

Demirkaya E

Çobanoglu N

Bilginer Y

Besbas N

Ozcelik U

Bakkaloglu A

Ozen S

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A Safe Protocol For Tuberculin Test Assessment In A Country Where Bcg Vaccination Is Mandatory

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A safe protocol for tuberculin test assessment in a country where BCG vaccination is mandatory

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Directory of Open Access Journals

Hacettepe University Institutional Repository