The role of chest X-rays when screening for latent tuberculosis infection in patients with inflammatory bowel disease before starting biologic treatment

Figures & data

Figure 1. Flow chart for the exclusionprocess of patients initially identified for the study.

Table 1. Characteristics of the study population consisting of inflammatory bowel disease patients screened for tuberculosis before starting biologic treatment.

Characteristics	Number	Percentage of total population	Median	Range
Sex
Male	227	44%
Female	293	56%
Age (years)			38	17–90
< 25	97	19%
25–50	286	55%
51–75	124	24%
>75	13	3%
IBD
Crohn’s disease	269	52%
Ulcerative colitis	229	44%
Pouchitis	16	3%
Check point inhibitor induced	3	1%
Unclassified	3	1%
BMI ($\mathit{\text{kg}}/m^2$)			25,6	14,1–68,0
< 18,5	8	2%
18,5–24,9	113	22%
25–29,9	85	16%
≥30	57	11%
Not recorded	257	49%
Last GC dose
Current	227	44%
< 1 month	48	9%
1–3 months	28	5%
> 3 months / never	216	42%
Not recorded	1	0%
GC types last 3 months
Methylprednisolone, i.v.	82	16%
Prednisolone, oral	175	34%
Budesonide, oral	94	18%
Prednisolone, suppositories	35	7%
Total GC last 3 months (mg)			160	10–3780
0	216	42%
1–500	124	24%
501–1000	65	13%
1001–1500	71	14%
1501–2000	15	3%
> 2000	13	3%
Not recorded	16	3%
Smoking
Current	112	22%
Former	140	27%
Never	248	48%
Not recorded	20	4%
Alcohol overconsumption*
Current	18	3%
Former	6	1%
Never	473	91%
Not recorded	23	4%
Drug abuse
Intravenous	0	0%
Other**	2	0%
No	228	44%
Not recorded	290	56%
Homelessness
Yes	0	0%
No	520	100%
Ethnicity
Danish	467	90%
Non-Danish	39	8%
Not recorded	14	3%
Travel to high endemic area***
Yes	11	2%
No	509	98%
Prior TB infection
Yes	4	1%
No	516	99%
Diabetes
Type 1	3	1%
Type 2	16	3%
GC induced	1	0%
No	499	96%
Not recorded	1	0%
Pulmonary disease
Yes	29	6%
No	490	94%
Not recorded	1	0%
Cardiovascular
Yes	25	5%
No	495	95%
Not recorded	0	0%
HIV
Yes	0	0%
No	520	100%
B-Hemoglobin			8,2	4,4–11
Normal/high	404	78%
Low	111	21%
Not recorded	5	1%
B-Leucocytes			8,5	2,02–31,3
High	234	45%
Normal/low	280	54%
Not recorded	6	1%
P-Ferritin			83	4–985
High/normal	471	91%
Low	42	8%
Not recorded	7	1%
P-Albumin			43	24–53
High/normal	477	92%
Low	38	7%
Not recorded	5	1%
P-CRP			4,8	0,4–233
High	223	43%
Normal	291	56%
Not recorded	6	1%
F-Calprotectin ($*{10}^{-6}$)			876	<15–>6000
Normal	19	4%
50–200	33	6%
201–1000	93	18%
1001–2500	74	14%
> 2500	53	10%
Not recorded	248	48%

* Overconsumption = >14 units per week for men and >7 units per week for women. 1 unit = 12 g alcohol.

** 1 for cocaine and 1 for amphetamine. Cannabis abuse not noted.

*** High-endemic = >99 cases per 100 000 per year (21).

Hemoglobin reference range (RR) = M: 8.3–10.5, F:7.3–9.5, mmol/L.

Leucocytes RR = 3.5–8.8 *${10}^9$/L.

Ferritin RR = M:22–355, F < 50 years:15–120, F > 49 years:15–290, µg/L.

Albumin RR = 18–39 years: 36–48, 40–69 years: 36–45, >69: 34–45, g/L.

CRP RR = < 6 mg/L.

Calprotectin = < 50 *. ${10}^{-6}.$

Abbreviations: IBD = Inflammatory bowel disease, BMI = Body mass index, GC = Glucocorticoid, HIV = Human immunodeficiency virus, B = Blood, P = Plasma, F = Feces.

Table 2. Test results for inflammatory bowel disease patients screened for tuberculosis before starting biologic treatment.

	TB suspect CXR	Non-suspect CXR
Positive QFT	1	7
Negative QFT	0	494
Inconclusive QFT	0	18

TB = tuberculosis QFT = QuantiFERON CXR = Chest X-ray.

Organization WH. WHO global lists of high burden countries for tuberculosis (TB), TB/HIV and multidrug/rifampicin-resistant TB (MDR/RR-TB), 2021–2025: background document; 2021.

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Data availability statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.