Screening before prolonged immunosuppressive therapy: Difference between revisions
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* Tuberculosis |
* [[Tuberculosis]] |
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** Screen if |
** Screen if planning [[prednisone]] ≥15mg daily for 1+ month |
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** TB skin test (false positive if BCG and needs a 48h repeat) |
** [[Tuberculin skin test|TB skin test]] (false positive if [[BCG]] and needs a 48h repeat) |
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*** Still useful to test up after up to two weeks of ≤20mg daily prednisone |
*** Still useful to test up after up to two weeks of ≤20mg daily [[prednisone]] |
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** IGRA (expensive) |
** [[Interferon-gamma release assay|IGRA]] (expensive) |
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* Hepatitis B |
* [[Hepatitis B]] |
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** Screen if >7.5mg |
** Screen if planning [[prednisone]] >7.5mg daily |
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** Treat if HbSag positive or if HbCAb and HBV-DNA positive |
** Treat if HbSag positive or if HbCAb and HBV-DNA positive |
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** Prophylaxis with |
** Prophylaxis with [[lamivudine]] for 6 months after the immune suppression is done |
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* Strongyloides |
* [[Strongyloides]] |
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** Screen with serology if has ever travelled to an endemic country |
** Screen with serology if has ever travelled to an endemic country |
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Latest revision as of 15:08, 12 December 2023
- Tuberculosis
- Screen if planning prednisone ≥15mg daily for 1+ month
- TB skin test (false positive if BCG and needs a 48h repeat)
- Still useful to test up after up to two weeks of ≤20mg daily prednisone
- IGRA (expensive)
- Hepatitis B
- Screen if planning prednisone >7.5mg daily
- Treat if HbSag positive or if HbCAb and HBV-DNA positive
- Prophylaxis with lamivudine for 6 months after the immune suppression is done
- Strongyloides
- Screen with serology if has ever travelled to an endemic country