P306 Tryptophan deficiency in Crohn's disease

Abstract

tuberculosis infection was confirmed by positive culture to Mycobacterium tuberculosis. Results: 225 patients received TNF alpha drugs: 136 male (60.4%), 173 (76.9%) Crohn’s disease. No patient had suffered from previous lung diseases. Tuberculin cutaneous test was documented in 190 patients, and Booster re-test in 100. Latent tuberculosis was diagnosed in 20 and 1 patients whether TCT or Booster were >5mms respectvely and all of them received oral isoniacide prophylaxis (9.3%). Seven patients suffered from active tuberculosis infection (3.1%): 4 male (57.1%) mean age 49.6 years 57.1% ulcerative colitis. Four of them had negative TCT and Booster but they were on inmunosuppresant but no corticosteroids when these tests were performed, and the other 3 patients had received oral quimioprofilaxis (3 6 months) because TCT was positive. Time from last TNF dose to symptoms and from symptoms to tuberculosis diagnose were and days respectively. Active tuberculosis were generally disseminated (85.5%) and required hospitalization until diagnose and clinical stabilization. Multidrug therapy was continued for 6 8 months but one patient eventually died. Anti TNF-alpha was no restarted in these patients. Conclusions: Active tuberculosis in IBD patients on antiTNF therapy in a high prevalence area was 3.1%. The infection was generally disseminated, required hospitalizations and even caused death. TCT test and previous oral quimioprofilaxis failed to eliminate risk of active infection in these patients, so any other tests or preventive measures should be develop.