Tuberculosis after renal transplantation: experience of one Turkish centre

Yildiz, Alaattin; Sever, Mehmet Şükrü; Türkmen, Aydın; Ecder, Tevfik; Beşışık, Fatih; Tabak, Levent; Ece, Turhan; Kilicarslan, I.; Ark, Ergin

doi:10.1093/ndt/13.7.1872

Cited by 63 publications

(76 citation statements)

References 2 publications

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“…In contrast to infections with classical mycobacteria, infections with atypical mycobacteria after organ transplantation are relatively uncommon. The isolated skin tuberculosis with atypical mycobacteria -as desribed in our case -without simultaneous affection of the lungs or other organs is an extremely rare complication [1,2].…”

Section: Discussionsupporting

confidence: 49%

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Skin Tuberculosis with Atypical Mycobacteria 8 Years after Combined Pancreas-Kidney Transplantation

Schmekal

Janko²,

Zazgórnik³

et al. 2002

Am J Nephrol

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We report on a Mycobacterium marinum infection in a diabetic woman 8 years after undergoing a combined pancreas-kidney transplantation. This is, to our knowledge, the first case report on an isolated skin infection with atypical mycobacteria after simultaneous pancreas-kidney transplantation. A genetic probe categorization revealed an infection with M. marinum. Skin tuberculosis caused by M. marinum is an uncommon complication in kidney or pancreas-kidney transplant recipients, hence the diagnosis can be delayed.

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Section: Discussionsupporting

confidence: 49%

“…The peak incidence takes place 1 year after the transplantation has been carried out [1]. The incidence of tuberculosis in solid-organ transplant recipients ranges worldwide from 0.35 to 15%.…”

Section: Introductionmentioning

confidence: 99%

Skin Tuberculosis with Atypical Mycobacteria 8 Years after Combined Pancreas-Kidney Transplantation

Schmekal

Janko²,

Zazgórnik³

et al. 2002

Am J Nephrol

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“…3 The evidence for the benefit of INH prophylaxis in renal transplantation is a challenging issue. Yildiz et al 12 had demonstrated that INH prophylaxis prevented posttransplant TB in patients with high risk of TB. Apaydin et al 13 retrospectively evaluated 274 renal transplant patients.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in Renal Transplant Recipients

et al. 2011

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Background: Renal transplant recipients should be considered at high risk for development of Mycobacterium tuberculosis infection (tuberculosis, TB). TB is relatively more frequent among transplant recipients than general population, depending on its epidemicity in the geographic region. Clinical manifestations in this group of patients may be atypical and deserve aggressive investigations for diagnosis. Tuberculin skin test has several limitations regarding diagnosis in chronic renal failure patients. In this retrospective study, we aimed to explore the prevalence and clinical manifestations of TB in renal transplant patients. Materials and methods: We retrospectively analyzed the data for TB prevalence, clinical presentations, and patient and graft survivals of total 320 pediatric and adult renal transplant recipients in our center between 1992 and 2010. Results: The prevalence of TB was 2.8%. Five patients received kidney from living-donor related and four from cadaveric donors. Cadaveric-donor patients received antithymocyte globulin for induction, and four patients received pulse steroid for acute rejection. The median duration of time between transplantation and TB was 21 (1-150) months, and between induction/pulse therapy and infection was 5 (1-100) months. The immunosuppressive protocols included prednisolone and cyclosporine/rapamycin with or without mycophenolate mofetil/azathioprine. The major symptoms were fever (77%), cough (66%), and abdominal pain (22%). Extrapulmonary TB with intestinal (2/9), pericardial (1/9), lymph node (1/9), and cerebral (1/9) involvements developed in five patients. One patient had both pulmonary and testicular involvements. All patients received quartet of anti-TB therapy for a median duration of 9 months. One patient died at the second month of therapy because of dissemination of TB, and one patient returned to hemodialysis because of chronic allograft nephropathy. Conclusion: The prevalence of TB was 2.8% in our renal transplant patients. The quartet of anti-TB treatment including rifampicin resulted in success in a majority of patients.

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“…A recent study reported that 32% of hemodialysis patients were anergic, 9% had a positive purified protein derivative (PPD) skin test, and 16% had a history of past or present exposure to tuberculosis (TB) (170). The prevalence of TB in renal transplant recipients is between 0.4 and 1.7% in the Western world (171,172) and up to 11.8% in developing countries where there is a higher rate of endemic tuberculosis (173)(174)(175)(176). Immunosuppression can cause aggressive disease with wide dissemination (171,(176)(177)(178)(179).…”

Section: Rationalementioning

confidence: 99%

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Tuberculosis after renal transplantation: experience of one Turkish centre

Cited by 63 publications

References 2 publications

Skin Tuberculosis with Atypical Mycobacteria 8 Years after Combined Pancreas-Kidney Transplantation

Skin Tuberculosis with Atypical Mycobacteria 8 Years after Combined Pancreas-Kidney Transplantation

Tuberculosis in Renal Transplant Recipients

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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