Renal Tuberculosis in the Modern Era

Daher, Elizabeth De Francesco; Silva, Geraldo Bezerra da; Barros, Elvino José Guardão

doi:10.4269/ajtmh.2013.12-0413

Cited by 110 publications

(96 citation statements)

References 41 publications

(55 reference statements)

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“…Moreover, the correlation was observed in the positive detection of ESAT-6 and IgA1 showed, indicating that MTB infection-induced renal injury was associated with the IgAN pathogenesis. Histologically, renal involvement in TB includes epithelioid granuloma, with or without caseation, and general Langhans-type giant cells (Daher Ede et al 2013). MTB can cause renal diseases through multiple pathways, among which genitourinary TB via direct invasion by the bacilli is most common (Eastwood et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Zhao

Sun

et al. 2017

Tohoku J. Exp. Med.

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IgA nephropathy (IgAN) is the most common cause of primary renal diseases worldwide, and the early secreted antigenic target of 6 (ESAT-6) which was secreted by Mycobacterium tuberculosis (MTB) may be involved in the development and progression of IgAN. This study aimed to investigate the role of ESAT-6 for early diagnosis of IgAN caused by MTB infection. From 2011 to 2014, 21 patients with renal tuberculosis (RTB), 25 with IgAN, and 46 with IgAN infected with MTB (IgAN/MTB) were enrolled. Serum levels of antibodies against Mycobacterium tuberculosis antigen 85A (Ag85A) were measured by ELISA. Urine culture and phage amplified biologically assay were performed to detect MTB. HE staining was used to observe the morphological changes in kidney tissues. Immunohistochemistry was applied to detect the expression of ESAT-6. Immunofluorescence staining was conducted to detect IgA1. Positive rates of serum anti-Ag85A antibody and urine culture for MTB were higher in the RTB and IgAN/MTB groups than those in the IgAN group. The positive rates of plaques were also higher in RTB and IgAN/MTB groups than the positive rate in the IgAN group. By contrast, the positive rate of ESAT-6 was lower in the IgAN group than that in the RTB group or the IgAN/MTB group, whereas the expression levels of IgA1 were higher in the IgAN and IgAN/MTB groups, compared with the RTB group. Our findings suggest that ESAT-6 and IgA1 may be helpful for early diagnosis of IgAN caused by MTB infection.

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Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Zhao

Sun

et al. 2017

Tohoku J. Exp. Med.

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“…1 Genitourinary TB is the third most common form of extrapulmonary TB after pleural TB and lymphatic TB in several countries, including Canada and the United States. 2,3 According to the Centers for Disease Control and Prevention, the number of TB cases reported and the case rate is decreasing, with a rate of 3 cases per 100 000 people in the United States in 2013. 7 Immunocompromised patients, particularly HIV patients, are more at risk of developing TB.…”

Section: Discussionmentioning

confidence: 99%

“…1 Genitourinary TB is the third most common form of extrapulmonary TB after pleural TB and lymphatic TB in North America. 2,3 Patients have non-specific symptoms and atypical presentations, which often lead to difficulty and delay in diagnosis. Urinalysis usually shows culture-negative pyuria and hematuria.…”

Section: Introductionmentioning

confidence: 99%

Genitourinary tuberculosis in North America: A rare clinical entity

Sourial

Brimo²,

Horn³

et al. 2015

CUAJ

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Introduction: Although tuberculosis (TB) is the most common cause of mortality from infectious diseases worldwide, genitourinary TB in North America is rare. We review 3 cases of genitourinary TB diagnosed within the last 5 years. Cases: The first case is that of a 76-year-old African-Canadian woman who was referred for percutaneous nephrolithotomy of right lower pole renal stones. Although renal TB was suspected, her initial urinary TB culture was negative. On follow-up imaging, she developed bilateral ureteral thickening and ureteroscopic biopsy confirmed necrotizing granulomata. Repeat urine cultures were positive for M. tuberculosis. The second case is a 73-yearold Italian-Canadian woman who was referred for ureteroscopic biopsy of left thickened ureter to rule out urothelial carcinoma. Initial urine TB cultures were negative, despite biopsies confirming granulomatous inflammation. She was closely followed with urine cytologies and TB cultures. Repeat urine culture was positive for M. tuberculosis. Both patients were treated with a course of anti-tuberculous agents and indwelling ureteral stents to relieve ureteral obstruction. The third case is a 70-year-old Cree woman who was referred for percutaneous nephrolithotomy of a left "staghorn stone" in an atrophic left kidney. Thirty years earlier she had been treated for pulmonary TB in addition to ileocystoplasty for a "thimble" bladder. A computed tomography scan showed autonephrectomized left kidney. Her urine TB cultures were negative. She was placed on prophylactic antibiotics for her recurrent bacterial urinary tract infections. Conclusion: Genitourinary TB may present in various subtle ways, and the astute clinician must have a high index of suspicion for this disease in patients with atypical clinical and radiologic findings. In addition, TB urine cultures should be repeated when there is high index of suspicion.

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“…Tuberkuloza bubrega može da se javi u sklopu diseminovanog oblika urogenitalne TBC ili kao lokalizovano oboljenje (8).…”

Section: Sažetakunclassified

“…Izonijazid se odlikuje dobrom penetracijom u tuberkulozno tkivo u letalnim koncentracijama, dok izonijazid, rifampicin i pirazinamid postižu visoku koncentraciju u mokraći. Antituberkulotici drugog reda se koriste u slučaju neefikasnosti lekova prve linije ili ispoljavanja rezistencije (5,8).…”

Section: Lečenjeunclassified