Monday, July 9, 2012

Tb or Not Tb? That is the Question

Thank you all for praying for Sawyer and for continuing to ask about him.  He’s home and doing well.  The steroids have made a tremendous difference in helping to manage the severe inflammation inside his GI tract, and the high-powered antibiotics appear to be relieving the secondary infection that appeared with the Crohn’s disease.


I would love for you all to join me in praying for an accurate diagnosis with regards to Tb.  Persons can have latent Tb where they are not contagious and do not have symptoms of Tb.  The problem with Tb and/or latent Tb with Remicade is that if a person has either form of Tb and begins Remicade treatments, they basically die or spend many months fighting for their lives.  Remicade apparently knocks out the body’s ability to fight off Tb, so they’re finding that one of the major risks of Remicade is death due to Tb. 


The other thing that has been discovered is that when a person has an autoimmune disease, their bodies don’t always react to the Tb test, so even if they had active Tb, they might get a negative reading on a Tb test.  Since Sawyer didn’t react to the control injection, his Tb test is basically not valid.


So the hospital did a chest X-ray to look for any signs of active Tb, and Sawyer’s chest X-ray looked “pristine” (doctor’s words).  That was good news, of course, but there’s still a very remote possibility that Sawyer could have latent Tb.  They consider Sawyer’s exposure to be higher risk because he’s traveled outside the US several times, plus he has a sibling with latent Tb.  Even though latent Tb is not contagious, there’s always a chance that a person’s latent Tb could turn into active Tb and then be contagious.  (Kind of like chicken pox.)   If a person with latent Tb gets Remicade, the result is often death.  Not good.


Sawyer’s blood was sent out to test for latent Tb.  We know he doesn’t have active Tb, but everything that can be done must be done to prove Sawyer doesn’t have latent Tb either.  The latent Tb blood test takes about a week to complete because the lab must watch the cells in the blood for a specific period of time in order to determine if there’s a possibility of latent Tb in the blood.  However, we’ve also been told that even if Sawyer’s blood test comes back negative for latent Tb, there’s still a chance he could have it because the reading can be a false negative or inconclusive due to Sawyer’s autoimmune disease.


So, in an effort to help determine that Sawyer doesn’t have active or latent Tb, the infectious disease docs asked me to have everyone in our family Tb tested.  We will all go this morning to have our Tb tests, and those will be read 48 hours after the injection.  Sawyer cannot get his Remicade infusion treatment until we all prove that none of us has active Tb that could have gotten transferred to Sawyer.


We would be most grateful for your prayers that all tests will be accurate, that Sawyer will not have latent Tb, and that he will be able to begin his Remicade infusion treatments this week so that his severe Crohn’s flare up can begin to clear up.  Feel free to pray that Jesus would completely heal him of this disease while you’re at it. :-)  Thank you!

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