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TB Reactivation on Anti-TNF — SCE Infectious Diseases MCQ

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HardTuberculosisTB Reactivation on Anti-TNFSCE Infectious Diseases

A man receiving high-dose corticosteroids for Crohn disease has a negative IGRA before planned infliximab. He previously lived in a country with high TB incidence and his chest radiograph shows apical fibrotic change. What is the best interpretation?

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Correct answer: C — Consider immune-related false negativity and investigate active and latent TB

A negative IGRA does not override substantial epidemiological and radiographic risk. The infliximab SmPC warns that false-negative TB tests can occur in severe illness or immunocompromise and requires evaluation for active and latent TB before treatment. Active disease must be excluded and the need for preventive treatment considered with specialist input before TNF blockade.

Reference: Remicade Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/3831/smpc