Tuberculin Purified Protein Derivative PPD

What is Tuberculin Purified Protein Derivative PPD

Tuberculin purified protein derivative (PPD) is an intradermally administered skin-test antigen used to screen individuals for latent tuberculosis infection (LTBI) to prevent them from developing active tuberculosis (TB) disease or to screen for persons who are infected with Mycobacterium tuberculosis (have active TB disease) that would benefit from treatment.

Purified protein derivative (PPD) tuberculin is isolated from culture media filtrates of a human strain of M. tuberculosis and is clinically bioequivalent in potency to the standard PPD-S (5 TU per 0.1mL) of the U.S.

Public Health Service, National Centers for Disease Control; each lot of manufactured product is tested prior to release, ensuring lot-to-lot consistency and potency.

In the U.S., tuberculosis testing should be performed in clearly defined high-risk groups, which include health care workers, persons with HIV infection, close contacts of persons with known or suspected TB, foreign-born persons, persons who were recently infected with M. tuberculosis, persons with high-risk substance abuse (injection of illicit drugs), or persons with a history of inadequately treated TB, among others.

The Mantoux tuberculin skin test, which consists of an intradermal injection of exactly 0.1 mL (5 units) of tuberculin PPD, is used to determine whether a person is infected with M. tuberculosis and is considered the standard testing method. Multiple puncture tests (MPTs) should not be used to determine whether a person is infected.

Once an individual has become sensitized to mycobacterial antigens, the skin test appears to stimulate or activate previously sensitized T cells to evoke a delayed hypersensitivity reaction at the site of the PPD administration.

Tuberculin purified protein derivative, PPD was first approved in the US as Tubersol in August 1956. A second PPD skin test, Aplisol, was approved in October 1972.

Brand Name

Aplisol

Tubersol

Indications

  • tuberculosis diagnosis

For tuberculosis diagnosis (e.g., diagnosis of latent tuberculosis infection (LTBI) or tuberculosis (TB) disease)

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. dyspnea
  4. edema
  5. erythema
  6. fever
  7. hematoma
  8. injection site reaction
  9. pruritus
  10. rash
  11. skin necrosis
  12. skin ulcer
  13. syncope
  14. urticaria
  15. vesicular rash

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • acquired immunodeficiency syndrome (AIDS)
  • breast-feeding
  • burns
  • children
  • corticosteroid therapy
  • diabetes mellitus
  • fungal infection
  • geriatric
  • herpes infection
  • Hodgkin lymphoma
  • human immunodeficiency virus (HIV) infection
  • immunosuppression
  • infants
  • infection
  • intramuscular administration
  • intravenous administration
  • leukemia
  • lymphoma
  • malabsorption syndrome
  • malnutrition
  • measles
  • neonates
  • neoplastic disease
  • pregnancy
  • radiation therapy
  • renal failure
  • sarcoidosis
  • subcutaneous administration
  • surgery
  • total gastrectomy
  • tuberculosis
  • vaccination
  • varicella
  • viral infection

Interactions

  • Adalimumab
  • Ado-Trastuzumab emtansine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Altretamine
  • Antineoplastic Agents
  • Arsenic Trioxide
  • Atezolizumab
  • Avelumab
  • Azacitidine
  • Azelastine; Fluticasone
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Beclomethasone
  • Belinostat
  • Bendamustine
  • Betamethasone
  • Bevacizumab
  • Bexarotene
  • Bleomycin
  • Blinatumomab
  • Brentuximab vedotin
  • Budesonide
  • Budesonide; Formoterol
  • Busulfan
  • Cabazitaxel
  • Calaspargase pegol
  • Capecitabine
  • Carboplatin
  • Carmustine, BCNU
  • Cemiplimab
  • Cetuximab
  • Chlorambucil
  • Ciclesonide
  • Cisplatin
  • Cladribine
  • Clofarabine
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Cyclophosphamide
  • Cytarabine, ARA-C
  • Dacarbazine, DTIC
  • Dactinomycin, Actinomycin D
  • Daratumumab
  • Daratumumab; Hyaluronidase
  • Daunorubicin
  • Daunorubicin Liposomal
  • Daunorubicin Liposomal; Cytarabine Liposomal
  • Decitabine
  • Deflazacort
  • Denileukin Diftitox
  • Denosumab
  • Dexamethasone
  • Dinutuximab
  • Docetaxel
  • Doxorubicin
  • Doxorubicin Liposomal
  • Durvalumab
  • Elotuzumab
  • Epirubicin
  • Eribulin
  • Estramustine
  • Etanercept
  • Etoposide, VP-16
  • Everolimus
  • Floxuridine
  • Fludarabine
  • Fludrocortisone
  • Flunisolide
  • Fluorouracil, 5-FU
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Gemcitabine
  • Gemtuzumab Ozogamicin
  • Hydrocortisone
  • Hydroxyurea
  • Ibritumomab Tiuxetan
  • Idarubicin
  • Ifosfamide
  • Infliximab
  • Inotuzumab Ozogamicin
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Iobenguane I 131
  • Ipilimumab
  • Irinotecan
  • Irinotecan Liposomal
  • Ixabepilone
  • L-Asparaginase Escherichia coli
  • Lomustine, CCNU
  • Lutetium Lu 177 dotatate
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Mechlorethamine, Nitrogen Mustard
  • Melphalan
  • Mercaptopurine, 6-MP
  • Methotrexate
  • Methoxsalen
  • Methylprednisolone
  • Midostaurin
  • Mitomycin
  • Mitotane
  • Mitoxantrone
  • Mogamulizumab
  • Mometasone
  • Moxetumomab pasudotox
  • Nanoparticle Albumin-Bound Paclitaxel
  • Necitumumab
  • Nelarabine
  • Nivolumab
  • Obinutuzumab
  • Ofatumumab
  • Olaratumab
  • Omacetaxine
  • Oxaliplatin
  • Paclitaxel
  • Panitumumab
  • Panobinostat
  • Pegaspargase
  • Pembrolizumab
  • Pemetrexed
  • Pentostatin
  • Pertuzumab
  • Plicamycin
  • Porfimer
  • Pralatrexate
  • Prednisolone
  • Prednisone
  • Procarbazine
  • Ramucirumab
  • Rituximab
  • Rituximab; Hyaluronidase
  • Romidepsin
  • Rubella Virus Vaccine Live
  • Streptozocin
  • Tagraxofusp
  • Talimogene Laherparepvec
  • Temozolomide
  • Temsirolimus
  • Teniposide
  • Thioguanine, 6-TG
  • Thiotepa
  • Topotecan
  • Tositumomab
  • Trabectedin
  • Trastuzumab
  • Trastuzumab; Hyaluronidase
  • Tretinoin, ATRA
  • Triamcinolone
  • Trifluridine; Tipiracil
  • Venetoclax
  • Vinblastine
  • Vincristine
  • Vincristine Liposomal
  • Vinorelbine
  • Vorinostat
  • Ziv-Aflibercept
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