Renal Allograft Tuberculosis: A Case Report

Alsoub, Hussam; Alousi, Faraj S. Al; Haider, Abdulrazzaq

doi:10.5144/0256-4947.2002.346

Cited by 4 publications

(10 citation statements)

References 15 publications

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“…Alsoub et al [9] have also described graft tuberculosis in association with disseminated disease. The disease was again diagnosed after the recipient was back on dialysis and a graft nephrectomy was performed for pyrexia.…”

Section: Discussionmentioning

confidence: 98%

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Renal allograft tuberculosis: report of three cases and review of literature

et al. 2009

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Renal transplant recipients are prone to a variety of infections due a persistent immunodepleted state. Incidence of tuberculosis in this population is much higher compared with the general population. While pulmonary tuberculosis still remains the commonest form in this population, renal allograft tuberculosis is very rare. We report two cases of isolated allograft tuberculosis and one case of allograft tuberculosis with coexistent pleuro-pulmonary and bone marrow involvement. All three cases had presented with pyrexia of unknown origin, wherein despite extensive investigations the cause was not found. In two cases the diagnosis was confirmed on histology. Two cases responded to non-rifampicin-based modified antitubercular treatment and one to conventional four-drug Rifampicin-based regimen. Graft function improved in two cases while in one case the graft was lost. Tuberculosis involving the renal allograft is a potential cause for graft dysfunction/loss and requires a high index of suspicion for diagnosis. Timely detection and early institution of therapy can help save the renal allograft.

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Section: Discussionmentioning

confidence: 98%

“…Although tubercular involvement of the graft has been reported to occur in association with disseminated tuberculosis, reports of isolated tuberculosis of the renal allograft are infrequent in the literature [4][5][6][7]. In the majority of such cases the diagnosis has been made after graft nephrectomy [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Renal allograft tuberculosis: report of three cases and review of literature

et al. 2009

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“…[848586] Tuberculous interstitial nephritis (TIN) can also be responsible for graft dysfunction/loss. [8788] The renal allograft and the patient can both be saved by timely detection and prompt treatment[72] as the mortality rate from TB is very high (on account of the immune suppression).…”

Section: Tb In Transplanted Kidneysmentioning

confidence: 99%

Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

Merchant

Bharati

Merchant

2013

Indian J Radiol Imaging

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This article reviews the computed tomography and magnetic resonance imaging (MRI) features of renal tuberculosis (TB), including TB in transplant recipients and immunocompromised patients. Multi detector computed tomography (MDCT) forms the mainstay of cross-sectional imaging in renal TB. It can easily identify calcification, renal scars, mass lesions, and urothelial thickening. The combination of uneven caliectasis, with urothelial thickening and lack of pelvic dilatation, can also be demonstrated on MDCT. MRI is a sensitive modality for demonstration of features of renal TB, including tissue edema, asymmetric perinephric fat stranding, and thickening of Gerota's fascia, all of which may be clues to focal pyelonephritis of tuberculous origin. Diffusion-weighted MR imaging with apparent diffusion coefficient (ADC) values may help in differentiating hydronephrosis from pyonephrosis. ADC values also have the potential to serve as a sensitive non-invasive biomarker of renal fibrosis. Immunocompromised patients are at increased risk of renal TB. In transplant patients, renal TB, including tuberculous interstitial nephritis, is an important cause of graft dysfunction. Renal TB in patients with HIV more often shows greater parenchymal affection, with poorly formed granulomas and relatively less frequent findings of caseation and stenosis. Atypical mycobacterial infections are also more common in immunocompromised patients.

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“…Los receptores de trasplante de órgano son susceptibles a una variedad de infecciones de patógenos comunes y oportunistas. Tales infecciones causan significante morbimortalidad y los países en vías de desarrollo son los que contribuyen a las mayores tasas de complicaciones (1) .…”

Section: Introductionunclassified

“…La incidencia de tuberculosis (TB) se encuentra en franco incremento en el mundo (2) y en el caso de los receptores de trasplante renal se convierte en serio problema, comprometiendo la sobrevida del injerto a largo plazo cuando no la del paciente (1,3) .…”

Section: Introductionunclassified

Tuberculosis en receptores de trasplante renal: experiencia en una unidad de trasplante renal de Perú

2016

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Introducción. El trasplante de órganos conlleva riesgo de contraer tuberculosis (TB) a resultas de la necesaria inmunosupresión concurrente. La literatura señala una incidencia de 0,35% a 15%. En nuestro medio, carecemos de datos al respecto. Objetivos. Explorar la epidemiología, cuadro clínico y pronóstico de la TB en receptores de trasplante renal en área endémica. Igualmente, efectuar el análisis de casos multidrogorresistentes (MDR). Diseño. Estudio retrospectivo. Institución. Departamento de Nefrología, Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. Material. Historias clínicas de casos de trasplante renal comprendidos en el período 1999-2014. Intervenciones. Se revisó en 619 casos de trasplante renal la instalación de tuberculosis, así como se efectuó el análisis de casos multidrogorresistentes. Principales medidas de resultados. Instalación de tuberculosis y casos multidrogorresistentes. Resultados. La TB se instaló en 22 pacientes (3,5%), incidencia mayor que la obtenida en la población general del país (96/100 000/anual). La fiebre (57%) y la tos crónica (28%) fueron los síntomas más comunes. La TB extrapulmonar (50%) predominó sobre la pulmonar (40%) y la diseminada (10%). La ocurrencia de TB fue mayoritariamente después del año (72%). Siete de los casos (28%) cursaron con creatinina mayor de 2 mg% al momento del diagnóstico y tres de ellos retornaron a diálisis. Hubo cuatro casos de TB MDR. Conclusiones. El diagnóstico temprano en base a la sospecha clínica de TB y el tratamiento oportuno mejora el pronóstico en esta población.

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Renal Allograft Tuberculosis: A Case Report

Cited by 4 publications

References 15 publications

Renal allograft tuberculosis: report of three cases and review of literature

Renal allograft tuberculosis: report of three cases and review of literature

Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part II

Tuberculosis en receptores de trasplante renal: experiencia en una unidad de trasplante renal de Perú

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