Negative conversion of T-SPOT results after hemodialysis: case series and literature review

Abstract Background Latent tuberculosis infection (LTBI) affects 11.9% of outpatients under maintenance hemodialysis in Japan. In addition, the risk of reactivation of LTBI in hemodialysis patients is up to 10–25 times higher than that in the general population. Therefore, the accurate diagnosis and...

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Main Authors: Masataro Toda, Ayumi Yoshifuji, Koji Hosoya, Motoaki Komatsu, Naoki Hasegawa, Munekazu Ryuzaki
Format: Article
Language:English
Published: BMC 2023-10-01
Series:Renal Replacement Therapy
Subjects:
Online Access:https://doi.org/10.1186/s41100-023-00510-2
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author Masataro Toda
Ayumi Yoshifuji
Koji Hosoya
Motoaki Komatsu
Naoki Hasegawa
Munekazu Ryuzaki
author_facet Masataro Toda
Ayumi Yoshifuji
Koji Hosoya
Motoaki Komatsu
Naoki Hasegawa
Munekazu Ryuzaki
author_sort Masataro Toda
collection DOAJ
description Abstract Background Latent tuberculosis infection (LTBI) affects 11.9% of outpatients under maintenance hemodialysis in Japan. In addition, the risk of reactivation of LTBI in hemodialysis patients is up to 10–25 times higher than that in the general population. Therefore, the accurate diagnosis and treatment for LTBI are extremely important. The interferon-γ release assays are widely used for screening LTBI; however, the impact of hemodialysis on the assay results has been uncertain. Case presentation Twenty-seven hemodialysis patients (17 males, 69.9 ± 10.1 year old) were performed T-SPOT®.TB test (T-SPOT) both before and after hemodialysis. In cases where T-SPOT results were different before and after hemodialysis, T-SPOT was re-evaluated in a same manner. As a result, two cases showed consistent T-SPOT diagnostic discrepancy before and after hemodialysis in two measurements. In the first case, T-SPOT was indeterminate/positive before hemodialysis, but changed to negative after hemodialysis. In the second case, T-SPOT was positive before hemodialysis, but changed to indeterminate after hemodialysis. Conclusions We experienced the negative conversion of T-SPOT after hemodialysis in cases of LTBI. T-SPOT may show false-negative when measured after hemodialysis due to immunomodulation caused by hemodialysis.
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spelling doaj.art-cd905a18e9ef49fa84aa2cadcc5f17fb2023-11-05T12:30:05ZengBMCRenal Replacement Therapy2059-13812023-10-01911410.1186/s41100-023-00510-2Negative conversion of T-SPOT results after hemodialysis: case series and literature reviewMasataro Toda0Ayumi Yoshifuji1Koji Hosoya2Motoaki Komatsu3Naoki Hasegawa4Munekazu Ryuzaki5Department of Nephrology, Tokyo Saiseikai Central HospitalDepartment of Nephrology, Tokyo Saiseikai Central HospitalDepartment of Nephrology, Tokyo Saiseikai Central HospitalDepartment of Nephrology, Tokyo Saiseikai Central HospitalDepartment of Infectious Diseases, Keio University School of MedicineDepartment of Nephrology, Tokyo Saiseikai Central HospitalAbstract Background Latent tuberculosis infection (LTBI) affects 11.9% of outpatients under maintenance hemodialysis in Japan. In addition, the risk of reactivation of LTBI in hemodialysis patients is up to 10–25 times higher than that in the general population. Therefore, the accurate diagnosis and treatment for LTBI are extremely important. The interferon-γ release assays are widely used for screening LTBI; however, the impact of hemodialysis on the assay results has been uncertain. Case presentation Twenty-seven hemodialysis patients (17 males, 69.9 ± 10.1 year old) were performed T-SPOT®.TB test (T-SPOT) both before and after hemodialysis. In cases where T-SPOT results were different before and after hemodialysis, T-SPOT was re-evaluated in a same manner. As a result, two cases showed consistent T-SPOT diagnostic discrepancy before and after hemodialysis in two measurements. In the first case, T-SPOT was indeterminate/positive before hemodialysis, but changed to negative after hemodialysis. In the second case, T-SPOT was positive before hemodialysis, but changed to indeterminate after hemodialysis. Conclusions We experienced the negative conversion of T-SPOT after hemodialysis in cases of LTBI. T-SPOT may show false-negative when measured after hemodialysis due to immunomodulation caused by hemodialysis.https://doi.org/10.1186/s41100-023-00510-2HemodialysisIGRAsT-SPOTMycobacterium tuberculosisLTBI
spellingShingle Masataro Toda
Ayumi Yoshifuji
Koji Hosoya
Motoaki Komatsu
Naoki Hasegawa
Munekazu Ryuzaki
Negative conversion of T-SPOT results after hemodialysis: case series and literature review
Renal Replacement Therapy
Hemodialysis
IGRAs
T-SPOT
Mycobacterium tuberculosis
LTBI
title Negative conversion of T-SPOT results after hemodialysis: case series and literature review
title_full Negative conversion of T-SPOT results after hemodialysis: case series and literature review
title_fullStr Negative conversion of T-SPOT results after hemodialysis: case series and literature review
title_full_unstemmed Negative conversion of T-SPOT results after hemodialysis: case series and literature review
title_short Negative conversion of T-SPOT results after hemodialysis: case series and literature review
title_sort negative conversion of t spot results after hemodialysis case series and literature review
topic Hemodialysis
IGRAs
T-SPOT
Mycobacterium tuberculosis
LTBI
url https://doi.org/10.1186/s41100-023-00510-2
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AT motoakikomatsu negativeconversionoftspotresultsafterhemodialysiscaseseriesandliteraturereview
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