Abdominal tuberculosis in renal transplant recipient. Presentation of a case and literature review

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Juan Carlos H Hernández-Rivera
Luis García-Covarrubias
María Alejandra Morinelli-Astorquizaga
María Juana Pérez-López
Mariana Salazar-Mendoza
José Guadalupe Cardona Chávez
José Ramón Paniagua-Sierra

Keywords

Immunosuppression, Kidney Transplantation, Tuberculosis, Antitubercular Agents

Abstract

Background: Kidney transplantation presents a susceptible point, and is related to infections; tuberculosis is a common and endemic etiology in a country like Mexico, where the most frequent presentation is the respiratory condition, the extrapulmonary is extremely ra

Case report: 33-year-old man with kidney disease of undetermined etiology, kidney transplant in 2003 (donor mother) with adequate evolution; presented with chronic graft nephropathy, with baseline creatinine of 1.8 mg / dL, immunosuppression with prednisone 10 mg every 24 hours, mycophenolate mofetil 500 mg every 8 hours and ciclosporin 100 mg every 12 hours; surgical intervention was performed due to acute abdomen, appendectomy and omentectomy with histopathological finding of tuberculosis, Dotbal, antiproliferative in suspension was started and decrease of calcineurin inhibitor. Adequate kidney function was recovered and maintained as well as control of the infectious disease during the maintenance period.

Conclusions: The management of immunosuppression is vital to find the right dose to avoid rejection and allow an immune response to infection, together with antimicrobial treatment.

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References

Meije Y, Piersimoni C, Torre-Cisneros J, Dilektasli A, Aguado M. Mycobacterial infections in solid organ transplant recipients. Clin Microbiol Infect. 2014;20(Suppl. 7):89-101.

 

Subramanian A, Morris MI. Mycobacterium tuberculosis Infections in solid organ transplantation. American Journal of Transplantation. 2013;13:68-76.

 

Hsin-Yun S. Treating tuberculosis in solid organ transplant recipients. Curr Opin Infect Dis. 2014;27:501-505.

 

Currie A, Knight S, Morris P. Tuberculosis in Renal Transplant Recipients: The Evidence for Prophylaxis. Transplantation. 2010;90:695-704.

 

Aguado J, Herrero J, Gavalda J. Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Transplantation. 1997;63:1278-1286.

 

Muñoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis. 2005;40:581-587.

 

Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid organ transplant recipients: impact and implications for management. Clin Infect Dis. 1998;27:1266-1277.

 

Preiksaitis JK, Green M, Avery RK. Guidelines for the prevention and management of infectious complications of solid organ transplantation. Am J Transplant. 2004;4(Suppl. 10):37-41.

 

Aguado J, Torre-Cisneros J, Fortún J, Benito N, Meije Y, Doblas A, et al. Tuberculosis in Solid-Organ Transplant Recipients: Consensus Statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clinical Infectious Diseases. 2009;48:1276-1284.

 

Segall L, Covic A. Diagnosis of tuberculosis in dialysis patients: Current Strategy. Clin J Am Soc Nephrol. 2010;5:1114-1122.

 

Carrillo-Esper R, Moreno-Castañeda L, Hernandez-Cruz A, Aguilar-Zapata D. Tuberculosis renal. Cir Cir. 2010;78:442-447.

 

Morris P, Knechtle S. Kidney transplantation: principles and practice. Seventh Edition. London: Elsevier Saunders; 2014.

 

Danovitch G. Handbook of kidney trasnsplantation. Fifth edition. Philadelphia, USA: Lippincott Williams & Wilkins; 2010.

 

Cek M, Lenk S, Naber KG, Bishop MC, Johansen TE, Botto H. EAU Guidelines for the Management of Genitourinary Tuberculosis. European Urology. 2005;48:353-362.

 

Carl P, Stark L. Indications for surgical management of tuberculosis. World J Surg. 1997;21: 505-510.

 

Ergun I, Ekmekci Y, Sengul S, Kutlay S, Dede F, Canbakan B, et al. Mycobacterium tuberculosis infection in renal transplant recipients. Transplant Proc 2006;38:1344-1345.

 

Canet E, Dantal J, Blancho G, Hourmant M, Coupel S. Tuberculosis following kidney transplantation: clinical features and outcome. A French multicentre experience in the last 20 years. Nephrol Dial Transplant. 2011;26:3773-3778.