Screening before prolonged immunosuppressive therapy: Difference between revisions

Latest revision as of 11:08, 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

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+* [[Tuberculosis]]
-= ID screening for prolonged immunosuppressive therapy =
+** Screen if planning [[prednisone]] ≥15mg daily for 1+ month
+** [[Tuberculin skin test|TB skin test]] (false positive if [[BCG]] and needs a 48h repeat)
-* Tuberculosis
+*** Still useful to test up after up to two weeks of ≤20mg daily [[prednisone]]
-** Screen if pred 15mg daily for 1+ month
+** [[Interferon-gamma release assay|IGRA]] (expensive)
-** TB skin test (false positive if BCG and needs a 48h repeat)
+* [[Hepatitis B]]
-*** Still useful to test up after up to two weeks of ≤20mg daily prednisone
+** Screen if planning [[prednisone]] &gt;7.5mg daily
-** IGRA (expensive)
-* Hepatitis B
-** Screen if &gt;7.5mg prednisone daily
 ** Treat if HbSag positive or if HbCAb and HBV-DNA positive
-** Prophylaxis with lemivudine for 6 months after the immune suppression is done
+** Prophylaxis with [[lamivudine]] for 6 months after the immune suppression is done
-* Strongyloides
+* [[Strongyloides]]
 ** Screen with serology if has ever travelled to an endemic country
+[[Category:Immunocompromised hosts]]