Tuberculosis in Renal Transplant Recipients: A Brazilian Center Registry

Guida, José Paulo; Rosane, D. Bignotto; Urbini-Santos, C.; Alves-Filho, G.; Resende, Mariângela Ribeiro; Mazzali, Marilda

doi:10.1016/j.transproceed.2009.01.075

Cited by 29 publications

(46 citation statements)

References 4 publications

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“…Two patients (12,5%) died due to TB-related complications in our study and 12.9% to more than 22 % of cases in other studies [21,26,55]. Mortality is higher when TB occurs during the first year after kidney transplantation, among poor-nourrished patients, treated with steroids and having hypoxia [59].…”

Section: Disscussionmentioning

confidence: 45%

“…Chronic allograft nephropathy is a serious complication observed in 65% of the cases and has a negative impact on the graft survival [20,34,39,55].…”

Section: Disscussionmentioning

confidence: 99%

“…It associated isoniazid at a daily dose of 300 mg for patients weighing more than 35 kg and 5 mg/kg in patients weighing less than 35 kg, and Pyridoxin at the dose of 50 mg daily for 1 year [11,17,48,55].…”

Section: Disscussionmentioning

confidence: 99%

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Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Boubaker¹,

Abderrahim²,

Abdallah³

et al. 2013

AJMSM

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Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. Post-transplant TB is a problem in successful long-term outcome of renal transplantation recipients. It is a life-threatening opportunistic infection that is frequently encountered, but the diagnosis is often delayed. With the emergence of newer potent immunosuppressive regimens and an increased incidence of TB in the general population, post-transplant TB among transplant recipients can be anticipated. Our objective was to describe the pattern and risk factors of TB infection, and the prognosis in our transplant recipients. This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed. 16 patients (3.2%) developed posttransplant TB with a mean age of 32.5 ± 12.7 (range: 13-60) years and a mean post-transplant period of 36,6 months (range: 12,3 months -15.9 years). The forms of the diseases were pulmonary in 10 /16 (62.6%), disseminated in 3/16 (18.7%) and extrapulmonary in 3/16 (18.7%). All patients initially received 4-drug combination therapy. Because of drug interaction, an increase in the dose of calcineurium inhibitor and steroid was done in 2 cases and in steroids alones in 1 case. Graft dysfunction was observed in 7 cases (43,7%) with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18.7%) during treatment. Reccurence were observed in 4 cases after early stop of treatment. Two patients (12.5%) died. Extrapulmonary and disseminated tuberculosis were observed in third of our patients. More than 9 months of treatment may be necessary to prevent recurrence.

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Section: Disscussionmentioning

confidence: 45%

“…Chronic allograft nephropathy is a serious complication observed in 65% of the cases and has a negative impact on the graft survival [20,34,39,55].…”

Section: Disscussionmentioning

confidence: 99%

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Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Boubaker¹,

Abderrahim²,

Abdallah³

et al. 2013

AJMSM

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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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“…It is mostly related to the severity of TB and the complications of anti-TB therapy. 24,25 Mortality is higher when TB occurs during the first year after kidney transplant, among poor-nourished patients, those treated with steroids, and those with hypoxia. 26 …”

Section: Discussionmentioning

confidence: 99%

Untitled

Barbouch

Hajji²,

Helal³

et al. 2017

Exp Clin Transplant

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Tuberculosis is one of the leading infections after renal transplant, particularly in developing countries where the incidence and prevalence in the general population are high. Diagnosis requires bacteriologic and histologic confirmation. Interactions among the antitubercular drugs and the immunosuppressive agents have to be considered while prescribing, and surveillance for adverse effects is required. Although rare, case reports are available on extrapulmonary tuberculosis in allograft recipients. Here, we present a 25-year-old kidney transplant recipient who was diagnosed with lymph node tuberculosis under uncommon circumstances but who had a good outcome. This case report illustrates the difficulties in diagnosis of tuberculosis, changes in therapeutic protocols, and prognostic factors and highlights the effects of infectious complications with immunosuppressive therapy in this particular patient population.

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Tuberculosis in Renal Transplant Recipients: A Brazilian Center Registry

Cited by 29 publications

References 4 publications

Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Cutaneous and articular tuberculosis in a renal transplant recipient

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