TB-IGRA shows 82%–84% sensitivity and 86% specificity for intestinal TB but can yield indeterminate results, as in our patient.[8] Indeterminate outcomes are more common in Asian populations, patients with low albumin, or anemia, complicating diagnosis.[10] In our endemic area, TB remains a primary consideration, especially given unstandardized testing at primary care; thus, we performed AFB and PCR before starting immunosuppression. The gene discussed is ALB; the disease is anemia.