Clinical features and outcomes of tuberculosis in kidney transplant recipients in <scp>B</scp>razil: a report of the last decade

Marques, Inara; Azevedo, Luiz Sergio; Pierrotti, Lı́gia Camera; Caires, Renato Antunes; Sato, Victor Augusto Hamamoto; Carmo, Lilian P. F.; Ferreira, Gustavo Fernandes; Gamba, C.; Paula, Flávio Jota de; Nahas, William Carlos; David‐Neto, Elias

doi:10.1111/ctr.12077

Cited by 40 publications

(48 citation statements)

References 32 publications

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“…Although not applicable to our patient, cyclosporine hastens presentation (5). The temporal course of our patient's case, with disease presentation within the first post-transplant year, is consistent with what others have observed (1,6) (Figure 3). Atypical presentations are common in solid organ transplant recipients (7), with frequent occurrence of extrapulmonary and disseminated TB (1).…”

Section: Question 1asupporting

confidence: 91%

“…Most cases consist of reactivation, in which latent disease had not been appreciated. Even when the TST is performed, it may not be a useful screening tool in patients with ESRD, because its sensitivity and specificity are on the order of 50% (6). False positives may occur from exposure to non-TB mycobacteria or prior Bacille Calmette-Guerin vaccination.…”

Section: Question 1amentioning

confidence: 99%

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American Society of Nephrology Quiz and Questionnaire 2013

Josephson

Perazella

Choi

2014

Clinical Journal of the American Society of Nephrology

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The nephrology quiz and questionnaire remains an extremely popular session for attendees of the Annual Meeting of the American Society of Nephrology. As in past years, the conference hall was overflowing with interested audience members. Topics covered by expert discussants included electrolyte and acid-base disorders, glomerular disease, ESRD/dialysis, and transplantation. Complex cases representing each of these categories along with single best answer questions were prepared by a panel of experts. Before the meeting, program directors of United States nephrology training programs answered questions through an Internet-based questionnaire. A new addition to the nephrology quiz and questionnaire was participation in the questionnaire by nephrology fellows. To review the process, members of the audience test their knowledge and judgment on a series of caseoriented questions prepared and discussed by experts. Their answers are compared in real time using audience response devices with the answers of nephrology fellows and training program directors. The correct and incorrect answers are then briefly discussed after the audience responds, and the results of the questionnaire are displayed. This article recapitulates the session and reproduces its educational value for the readers of CJASN. Enjoy the clinical cases and expert discussions.

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Section: Question 1asupporting

confidence: 91%

Section: Question 1amentioning

confidence: 99%

American Society of Nephrology Quiz and Questionnaire 2013

Josephson

Perazella

Choi

2014

Clinical Journal of the American Society of Nephrology

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“…Development of NTM infection during the first year post-transplantation was strongly associated with decreased survival, which was independent of organ type. Similar to CMV infection, the mechanism for the impact of early NTM infection on survival may be multifactorial, including indirect effects exerted through immune modulation [12], transplant rejection [13], or development of secondary nosocomial infections [14], as suggested by our review of death certificates where available.…”

Section: Discussionmentioning

confidence: 99%

Non-tuberculous mycobacterial infections after solid organ transplantation: a survival analysis

Longworth

Blumberg

Barton

et al. 2015

Clinical Microbiology and Infection

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The relationship of nontuberculous mycobacterial (NTM) infections and survival among solid organ transplant (SOT) recipients is unknown. We conducted a retrospective cohort study to measure the impact of NTM infection on survival in this patient population, comparing the effect of M. abscessus infection versus infection due to other pathogenic NTM species. We identified 33 patients with NTM infection post-transplantation, 18 with infection that was diagnosed within the first year. Although drug resistance was common among M. abscessus isolates, patients with M. abscessus infection did not have increased mortality compared to patients with other types of NTM infections (p=0.64). In contrast, we observed a significant association overall between early NTM infection and 3-year mortality post-transplantation (HR 8.76, 95% CI 2.69, 28.57). The mortality burden of NTM infection following transplantation may be due to factors other than the virulence of the organisms. Multicenter studies are needed to identify the optimal approach for diagnosing and treating these uncommon but serious infections.

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“…Relying on automatized culture is the best option, but it usually takes time and may not be available. In developing countries, such as Brazil, pulmonary TB is much more common than extra-pulmonary TB, especially the cutaneous form of the disease [4][5][6] . The clinical presentation of cutaneous/subcutaneous TB is quite varied and includes inflammatory papules, verrucous plaques, suppurative nodules, and chronic ulcers 7 .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous and articular tuberculosis in a renal transplant recipient

Moysés-Neto

Drumond

Morgantetti

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Seven months after undergoing kidney transplantation, a 56-year-old woman presented with papules and ulcers in her right forearm. The patient received antibiotics for 8 months with limited improvement. Eleven months after symptom onset, she presented with acute arthritis in her left knee. Asynovial fluid culture yielded Mycobacterium tuberculosis, and a forearm ulcer biopsy showed granulomatous inflammation. After surgical fistulectomy and 12 months of tuberculosis treatment, she was cured. Chronic cutaneous ulcers and articular manifestations in TB are rare, but they should always be considered in the differential diagnosis for immunosuppressed patients. Surgical intervention and prolonged treatment might be necessary.

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Clinical features and outcomes of tuberculosis in kidney transplant recipients in Brazil: a report of the last decade

Abstract: Among KTRs, symptoms of tuberculosis are often attenuated, which leads to delayed diagnosis, and tuberculosis-related mortality remains high.

Cited by 40 publications

References 32 publications

American Society of Nephrology Quiz and Questionnaire 2013

American Society of Nephrology Quiz and Questionnaire 2013

Non-tuberculous mycobacterial infections after solid organ transplantation: a survival analysis

Cutaneous and articular tuberculosis in a renal transplant recipient

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