An unusual case of both upper and lower gastrointestinal bleeding in a kidney transplant recipient

Siu, Yui-Pong; Tong, M.K.H.; Kwok, Y.L.; Leung, Ken Cham Fai; Kwan, Tze-Hoi; Lam, Carolyn S.P.; Au, Tak Cheung

doi:10.1111/j.1399-3062.2007.00286.x

Cited by 18 publications

(19 citation statements)

References 12 publications

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“…1,4,5 Relatively few cases of GI-TB presenting with blood per rectum have been reported in the literature. 2,6 Sources of blood per rectum include rectal TB where this is the most frequent presenting symptom and colonic TB where there is usually minor bleeding. Overall only 4% of lower gastrointestinal bleeding is attributable to TB.…”

Section: Discussionmentioning

confidence: 99%

An unusual presentation of intra-abdominal tuberculosis in a young man

2010

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Section: Discussionmentioning

confidence: 99%

An unusual presentation of intra-abdominal tuberculosis in a young man

2010

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“…Some relatively uncommon cases were also reported, including intestinal TB, renal TB, breast TB, and tuberculous orchitis. [13][14][15][16] In the present study, the incidence of TB in nondialysis-requiring CKD group was 10.3% in which pulmonary TB was 3.9% while extrapulmonary TB was 6.4%. Among extrapulmonary TB, 52% positivity was seen in pleural effusion, 16.40% in ascetic fluid, 10.10% in lymphnodes, 7.4% in urinary tract, 3.7% in CSF, 2.6% in pericardial fluid, 1.6% in adrenal tissue and 1.1% in spine.…”

Section: Discussionmentioning

confidence: 99%

Incidence of tuberculosis in nondialysis-requiring CKD patients

Narain¹,

Gupta

2018

Int J Adv Med

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Background: Tuberculosis is a common infection of chronic kidney disease patients in developing countries.Methods: A retrospective study of 2960 non-dialysis requiring chronic kidney disease patients was made to determine the incidence and understand the demographic features of patients that lead to the development of tuberculosis on the basis of cell count, routine, ADA estimation, ZN stain, culture and PCR.Results: Between Jan 2000 and March 2017, the incidence of tuberculosis in no dialysis-requiring chronic kidney disease group was 10.3% in which pulmonary tuberculosis was 3.9% while extrapulmonary tuberculosis was 6.4%. Among extrapulmonary tuberculosis, 52% positivity was seen in pleural effusion, 16.40% in ascetic fluid, 10.10% in lymphnodes, 7.4% in urinary tract, and 3.7% in CSF, 2.6% in pericardial fluid, 1.6% in adrenal tissue and 1.1% in spine. ZN stain was positive in 48.6%, culture isolated mycobacterium 98.3%, PCR 93.4%, the mean ADA levels was 22.90+11.24 IU/ml and 60.49+07.24 IU/ml in CSF and body fluids respectively. Outcome analysis revealed 15.4% mortality rate in diagnosed tuberculosis cases while maximum loss of life was seen in diabetic patients.Conclusions:In the present study we observed 10.3% incidence of tuberculosis among nondialysis-requiring chronic kidney disease patients. Extrapulmonary form of tuberculosis predominates over pulmonary form. Unusual presentation and lococalization of symptoms should not be overlooked. Prompt and early diagnosis of tuberculosis is especially required in endemic areas.

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“…The gold standard remains characteristic histomorphological findings with demonstration of AFB and/or growth of MTB in culture. [17]…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in a renal allograft recipient presenting with intussusception

et al. 2012

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Extra-pulmonary tuberculosis (TB) is more common in renal allograft recipients and may present with dissemination or an atypical features. We report a renal allograft recipient with intestinal TB presenting 3 years after transplantation with persistent fever, weight loss, diarrhea, abdominal pain and mass in the abdomen with intestinal obstruction. He was diagnosed to be having an ileocolic intussusception which on resection showed a granulomatous inflammation with presence of acid-fast bacilli (AFB) typical of Mycobacterium tuberculosis. In addition, AFB was detected in the tracheal aspirate, indicating dissemination. He received anti-TB therapy (ATT) from the fourth postoperative day. However, he developed a probable immune reconstitution inflammatory syndrome (IRIS) with multiorgan failure and died on 11th postoperative day. This is the first report of intestinal TB presenting as intussusception in a renal allograft recipient. The development of IRIS after starting ATT is rare in renal allograft recipients. This report highlights the need for a high index of suspicion for diagnosing TB early among renal transplant recipients and the therapeutic dilemma with overwhelming infection and development of IRIS upon reduction of immunosuppression and starting ATT.

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An unusual case of both upper and lower gastrointestinal bleeding in a kidney transplant recipient

Abstract: Diagnosing TB intestinal infection is a clinical challenge. A high index of suspicion in susceptible subjects is necessary, and early surgical intervention should always be considered when facing diagnostic uncertainties.

Cited by 18 publications

References 12 publications

An unusual presentation of intra-abdominal tuberculosis in a young man

An unusual presentation of intra-abdominal tuberculosis in a young man

Incidence of tuberculosis in nondialysis-requiring CKD patients

Tuberculosis in a renal allograft recipient presenting with intussusception

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