AIDS-Associated Renal Tuberculosis

Abstract

In order to study the prevalence and the clinical features of renal tuberculosis associated with AIDS, we studied the renal tissue of the necropsies made in 46 AIDS patients under light microscopy. We found renal tuberculous granuloma in 11 (23%) patients (in 3 without previous diagnosis of renal or extrarenal tuberculosis) and only 4 of them presented moderate hematuria or pyuria sterile. As subclinical renal tuberculosis was frequent in this group of AIDS patients, the urine culture for Mycobacterium tuberculosis may be useful for diagnosing tuberculosis in AIDS patients.

The urologist and the patient infected with human immunodeficiency virus or with acquired immunodeficiency syndrome

“…In autopsy studies of patients with AIDS, renal TB was identi®ed in 6±23% [22,23]. Although most of these patients had signs and symptoms of pulmonary TB, 20% had subclinical disease [22]. M. tuberculosis is the most frequent cause of renal TB, and less frequently M. avium and M. intracellulare [24].…”

Urogenital tuberculosis in immunocompromised patients

“…Human immunodeficiency virus (HIV) infection increases the risk of tuberculosis either by reactivation of latent foci, or by rapid progression of a newly acquired infection or reinfection [3]. Between 20% and 50% of the HIV-infected population worldwide have active tuberculosis [4,5]. Thirty percent of the world population (1.7 billion people) are estimated to harbor Mycobacterium tuberculosis, and although more than 90% of the new cases of tuberculosis occur in developing countries, the higher incidence of AIDS-related tuberculosis makes this infection a chief concern even in developed countries [1,3].…”

“…In the USA, from 1,282 patients diagnosed with tuberculosis between 1991 and 1997 in an inner-city hospital, 46% had HIV coinfection [6]. An autopsy study of 46 AIDS patients in Brazil revealed that 54.3% had tuberculosis, the disseminated form being the most frequent one [4].…”

“…Although in renal transplant patients pleuropulmonary and disseminated tuberculosis are the most common forms, the urogenital presentation may be the predominant one in developing countries [7,8]. In recent reports, an impressive two-thirds of patients with urogenital tuberculosis had AIDS [6], and 23.9% of AIDS patients had renal tuberculosis granulomata, most of whom without voiding symptoms, hematuria, or microscopic leucocyturia [4].…”

Modern imaging of renal tuberculosis in children

“…Renal tuberculosis (TB) is uncommon in children, but needs to be considered especially in disseminated disease as specific interventions would be required 1–3 . An increase in the incidence of renal TB can be anticipated with the spread of the AIDS 4 . Imaging of renal TB in children differs from adults in that intravenous urography (IVU) is no longer considered a routine investigation for renal tract symptoms because of the radiation burden.…”