Author: Meg (68.190.163.---)
Date: 09-15-03 23:08
Olive,
Brain fog is something with which most of us are familiar. But , happily, it is one of the first symptoms to resolve when 1,25-D is under control.
As this article points out, TB skin tests on patients treated with immunospressants are not reliable because they result in false-negatives.
Due to a phenomenon called cutaneous anergy, sarcoidosis patients may also have false negative TB skin tests even when not treated with immunosuppressants. Here is an explanation of cutaneous anergy from uveitis.org
Cutaneous anergy
In 1916, Boeck first described cutaneous anergy to tuberculin in patients with sarcoidosis. It was later on realized that this phenomenon was not limited to tuberculin alone, but that anergy to a variety of other skin tests-antigens such was also typical. In 1994, Kataria and Holter proposed a mechanism for the cutaneous anergy seen in sarcoidosis. At sites of granulomatous inflammation, there is a predominance of helper T lymphocytes, which proliferate and secrete large amounts of lymphokines, including interleukin (IL)-2, monocyte chemotactic factor (MCF) and migration inhibition factor (MIF). These lymphokines induce and amplify the immune response by enhancing T-lymphocyte proliferation as well as recruiting and retaining monocytes from the circulation. The lymphokines and monokines produced at sites of granulomatous inflammation have their highest concentration locally. Nevertheless, the protein molecules diffuse into blood, establishing a concentration gradient between the granulomatous inflammatory site and the remote site of the delayed type hypersensitivity (DTH) skin test. As a result, the traffic of T-helper lymphocytes and monocytes is preferentially directed towards site of granuloma formation. That leads to a preponderance of suppressor cells in the peripheral blood and competitively depletes the T-helper cells and monocytes available to sites of DTH.
It isn't dangerous to be tested for TB but for sarc patients it will not give you much information. When you say that you've never had a positive TB skin test do you mean that you had a normal reaction or that there was NO reaction? It is normal to have faint erythema at the injection site but with cutaneous anergy you will see NOTHING. I thought that was 'normal' until I was diagnosed with sarcoidosis. I just had my annual test and once again, NOTHING.
Meg
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