Buradasınız

Anasayfa » Content

Böbrek Hastalarında, Atipik Ekstrapulmoner Tüberküloz

(A)typical (Extra) Pulmonary Tuberculosis in Kidney Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2010
DOI: 
10.5262/tndt.2010.1001.14

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Tuberculosis is still a major health problem especially among immunocompromised hosts. Another problem is making diagnosis due to the unexpected presentation and localization of disease. Extrapulmonary disease may clinically and radiographically mimic other infectious or neoplastic diseases. In this report we presented three tuberculosis cases; a kidney allograft recipient and two patients with end stage renal disease including soft tissue abscess, lytic bony lesions and pathological fractures without any pulmonary symptoms. Tuberculosis should be kept in mind during atypical generalized inflammatory conditions especially in immunocompromised hosts. Atypical localization and symptomatology may arise due to the more potent immunosuppressive agents. Delay in diagnosis may cause significant mortality and morbidity in patients with high risk. Starting anti-tuberculosis treatment empirically in most cases due to the difficulties in establishing diagnosis is another problem. Classical anti-tuberculosis treatment is sufficient to control disease in most cases. Early management may be a life saving approach.
Bookmark/Search this post with
Abstract (Original Language): 
Tüberküloz, özellikle immün sistemi baskılanmış kişilerde, ciddi bir sağlık problemi olmaya devam etmektedir. Beklenmedik bulgu ve semptomlarla ortaya çıkabilmesi sebebiyle tanı koymada zorluklara sebep olmaktadır. Pulmoner sistem dışı hastalık formu, benzer klinik ve radyolojik bulguları sebebi ile diğer birçok enfeksiyöz ve/veya neoplastik hastalığı taklit edebilmektedir. Biz bu makalede, iki son dönem böbrek yetmezliği hastası ve bir transplant hastası olmak üzere 3 hastamızda; yumuşak doku absesi, kemik lezyonları ve patolojik kırıklarla seyreden, hiç pulmoner semptom oluşturmayan tüberküloz vakalarımızı irdeledik. Özellkle immün sistemi baskılanmış hastalarda, atipik yaygın inflamasyon varlığında tüberküloz akılda tutulması gereken bir hastalıktır. Semptomatoloji ve lokalizasyondaki farklılık, etkinliği güçlü immün sistem baskılayıcı ajanlardan kaynaklanıyor olabilir. Tanıda gecikme özellikle bu hastalarda anlamlı mortalite ve mobiditeye sebep olabilir. Kesin tanı koymadaki zorluklar sebebiyle çoğu vakada genellikle ampirik anti tüberküloz tedavi başlatmak gerekliliği bir diğer problemdir. Klasik anti-tüberküloz tedavi, hastalığın control altına alınmasında yeterlidir. Erken müdahale hayat kurtarıcı olabilir.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_19_pp_73-76.pdf
  • 1
73-76
  • Turkish

REFERENCES

References: 

1. Pradhan RP, Katz LA, Nidus BD, Matalon R, Eisinger RP:
Tuberculosis in dialyzed patients. JAMA 1974;229: 798–800
2. Hussein MM, Mooji MJ, Roujouleh H: Tuberculosis and chronic
renal disease. Semin Dial 2003;16(1):38-44
3. Alvarez S, McCabeWR: Extrapulmonary tuberculosis revisited: A
review of experience at Boston City and other hospitals. Medicine
1984;63:25–55
4. Poucht J, Dreyfuss D, Gardin JP: Ectopic production of 1,25-
dihydroxyvitamin D3 in tuberculosis. Nephrol Dial Transplant
1993;8: 560-562
5. Hwang S, Simsir A, Waisman J, Moreira AL: Extrapulmonary
tuberculosis as a mimicker of neoplasia. Diagnostic Cytopathology
2004;30 (2): 82-87
6. Sakhuja V, Varma PP, Kathuria P, Jha V, Chugh KS: Bone
tuberculosis: An unusual case of mycobacterial infection in a renal
allograft recipient. Nephrol Dial Transplant 1993; 8: 868-870
7. Chou KJ, Fang HC, Bai KJ, Hwang SJ, Yang WC, Chung HM:
Tuberculosis in maintenance dialysis patients. Nephron 2001;
88(2):138-143
8. Torre-Cisneros J, Doblas A, Aguado JM, San Juan R, Blanes M,
Montejo M, Cervera C, Len O, Carratala J, Cisneros JM, Bou G,
Muñoz P, Ramos A, Gurgui M, Borrell N, Fortún J, Moreno A,
Gavalda J: Spanish Network for Research in Infectious Diseases:
Tuberculosis after solid-organ transplant: incidence, risk factors,
and clinical characteristics in the RESITRA (Spanish Network
of Infection in Transplantation) cohort. Clin Infect Dis 2009
15;48(12):1657-1665
9. Peces R, de la Torre M, Alcazar R, Tejada F, Gago E: Genitourinary
tuberculosis as the cause of unexplained hypercalcaemia in a
patient with pre-end-stage renal failure. Nephrol Dial Transplant
1998;13 (2): 488–490
10. Ascher NL, Simmons RL, Marker S: Tuberculous joint disease in
transplant patients. Am J Surg 1978;135: 853-856
11. Pien FD, Younoszai BG, Pien BC: Mycobacterial infections in
patients with chronic ren al disease. In: Berman SJ, Pien FD (eds).
Infections in patients with chronic renal disease. Infect Dis Clin N
Am 2001;15:851–876
12. Concia E, Prandini N, Massari L, Ghisellini F, Consoli V,
Menichetti F,Lazzeri E: Osteomyelitis: Clinical update for
practical guidelines. Nucl Med Commun 2006 ;27(8):645-660
13. Naqvi R, Naqvi A, Akhtar S, Ahmed E, Noor H, Saeed T, Akhtar
F, Rizvi A: Use of isoniazid chemoprophylaxis in renal transplant
recipients. Nephrol Dial Transplant 2010; 25 (2): 634-637
14. Vikrant S, Agarwal SK, Gupta S, Bhowmik D, Tiwari SC, Dash
SC, Guleria S, Mehta SN: Prospective randomized control trial
of isoniazid chemoprophylaxis during renal replacement therapy.
Trasplant Infect Dis 2005;7(3-4):99-108
15. Aronoff GR, Berns JS, Brier ME, Golper TA, Morrison G, Singer
I, Swan SK, Bennett WM: Drug Prescribing in Renal Failure.
Dosing Guidelines for Adults, (4th ed). Philadelphia: American
College of Physicians, 1999

Thank you for copying data from http://www.arastirmax.com