Tuberculous spondylitis in patients with end-stage renal disease undergoing chronic hemodialysis therapy — Report of two cases

Abstract

<jats:title>Abstract</jats:title><jats:p>Tuberculous spondylitis is more common in patients with chronic renal failure who receive hemodialysis because of their abnormal T-cell-mediated immunity. It frequently poses both diagnostic and therapeutic challenges. We describe two cases of tuberculous spondylitis in patients undergoing chronic hemodialysis therapy. They are IFN-γ assay diagnosed (QuantiFERON-TB Gold) and conservatively treated. Our cases suggest that IFN-γ assays equip clinicians with more accurate tools for tuberculosis control. A combination of T-SPOT.TB testing and MRI assessment may be the accurate method to diagnose tuberculous spondylitis in patients with end-stage renal disease.</jats:p>

Increased risk of tuberculosis in patients with end-stage renal disease: a population-based cohort study in Taiwan, a country of high incidence of end-stage renal disease

“…A previous investigation reported increased incidence rates (6•9-to 52•5-fold) of TB in patients with ESRD and also receiving dialysis compared to the general population [5]. Some previous studies have described a higher incidence of TB in ESRD patients [4,[6][7][8]. However, those results might not be generalizable because they were a case report [7], a case-control study [6], used a small-sized sample from a university hospital [4], or evaluated selfreported TB disease and previous TB contact, which might thus be subject to recall bias [8].…”

“…Some previous studies have described a higher incidence of TB in ESRD patients [4,[6][7][8]. However, those results might not be generalizable because they were a case report [7], a case-control study [6], used a small-sized sample from a university hospital [4], or evaluated selfreported TB disease and previous TB contact, which might thus be subject to recall bias [8]. The previous studies also had no control group, or did not observe the incidence of ESRD cases and follow them long enough to investigate the ensuing risks of TB.…”