Tuberculosis in southern Chinese renal‐transplant recipients

Chen, Siyang; Wang, Changxi; Chen, Lizhong; Fei, Ji-guang; Deng, Shijie; Qiu, Jian; Li, Jun; Chen, Guodong; Fu, Hongmei; Xie, Canmao

doi:10.1111/j.1399-0012.2008.00878.x

Cited by 33 publications

(35 citation statements)

References 8 publications

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“…It continues to be the most common form in kidney transplant recipients [29]. Pulmonary signs were observed in 37,5% of the cases particularly coughing (12,5 % of the patients) versus 56.1% in literature accompanied by spittles in 39 % of the cases [26]. No case of hemoptysis was reported in our study while they are observed in 20 % in other studies [30].…”

Section: Disscussioncontrasting

confidence: 51%

“…Common clinical abnormalities include pyrexia, pulmonary infiltrates, exudative pleural effusion, and exudative ascites. In our study, moderate and permanent fever of unknown origin was observed in 93,7% of cases versus 71% to 82,9 % in literature [4,25,26,27]. Impairment of the general state was observed in 31,2% patients in our study versus 40 % in literature [27,28].…”

Section: Disscussioncontrasting

confidence: 42%

“…Low sensitivity of 50% for predicting post-transplant TB is explained by anergy due to deterioration of cellular immunity particularly in poor-nourished and anaemic patients, males, elderly, smokers, patients with hepatic pathology, peptic ulcer and/or prolonged duration of pretransplant hemodialysis [43,44,45,46]. Sensitivity of skin-test increases to 75% in kidney transplant recipients after exclusion of patients with anergy [9,26,34]. The sensitivity of the skin-test is not affected by BacillusCalmette -Guerin (BCG) vaccine [43].…”

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: Disscussioncontrasting

confidence: 51%

Section: Disscussioncontrasting

confidence: 42%

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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“…1,8,9 Seven of the patients in our study were successfully treated by rifampicin-included quartet of therapy for a median duration of 9 months. All had well-functioning allografts.…”

Section: Discussionmentioning

confidence: 99%

“…4 In accordance with our result, data from Southern China and Thailand, where TB epidemicity was also high, demonstrated prevalence rates ranging from 1.76% to 12.96%. 8,9 Diagnosis of TB depends on demonstration of acidfast bacilli in study materials, cultivating the microorganism in special media, and presence of caseating granuloma with or without acid-fast bacilli in histological specimens. The tuberculin skin test, on the other hand, is a screening test to reveal the history of contact with M. tuberculosis.…”

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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The Roles of Timosaponin in Inhibiting Adherence of Fungus and Enhancing Function of Phagocyte

Liu

et al. 2012

Advances in Intelligent and Soft Computing

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Tuberculosis in southern Chinese renal‐transplant recipients

Cited by 33 publications

References 8 publications

Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Tuberculosis in Renal Transplant Recipients

The Roles of Timosaponin in Inhibiting Adherence of Fungus and Enhancing Function of Phagocyte

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