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tuberculosis in renal transplant patients

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https://www.readbyqxmd.com/read/27920569/does-calcium-channel-blockade-have-a-role-in-prevention-of-expression-of-sepsis-in-renal-transplant-recipients
#1
REVIEW
John A D'Elia, Ray E Gleason, Anthony P Monaco, Larry A Weinrauch
Many antihypertensive agents have been demonstrated to assist in preservation of kidney function, among them those that modulate calcium channels. Calcium channel blockers may also be of value in protecting hemodialysis patients from complications of sepsis. In diabetic recipients of kidney transplant allografts treated with cyclosporine, calcium channel blockade has been retrospectively linked to improved graft preservation and to fewer episodes of sepsis. This brief review outlines clinical and experimental publications on potential protection from sepsis by addition of calcium channel blockers to standard antibiotic therapy in individuals who may or may not have normal kidney function, or in the presence or absence of immunosuppression...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27885762/esophageal-tuberculosis-with-coexisting-opportunistic-infections-in-a-renal-allograft-transplant-recipient
#2
Sunil Kumar, Mukut Minz, Saroj K Sinha, Kim Vaiphei, Ashish Sharma, Sarbpreet Singh, Deepesh B Kenwar
We report a renal allograft transplant recipient with esophageal tuberculosis (TB) coinfected with herpes simplex virus (HSV) and Candida. The patient presented with oropharyngeal candidiasis and was started on fluconazole. Upper gastrointestinal endoscopy showed whitish patches with mucosal ulcers in the esophagus. Histopathological examination confirmed TB and HSV infection. The patient recovered after antiviral, antifungal, and anti-tubercular therapy with reduction in immunosuppression. In a TB-endemic zone, TB can coexist with opportunistic infections in an immunocompromised host...
November 25, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27852682/disseminated-mycobacterium-tuberculosis-following-renal-transplant-with-alemtuzumab-induction
#3
Adam Baghban, Marwan Mikheal Azar, Raffaele Mario Bernardo, Maricar Malinis
Mycobacterium tuberculosis presents unique challenges in the peritransplant period. Here, we describe a case of disseminated tuberculosis following renal transplantation with alemtuzumab induction immunosuppression in a patient with remotely treated pulmonary tuberculosis and ongoing risk factors for re-infection. We also review the available literature regarding the prevalence of tuberculosis infection following solid organ transplant and management of high-risk patients, including the role for isoniazid preventative therapy...
November 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27775825/impact-of-type-of-calcineurin-inhibitor-on-post-transplant-tuberculosis-single-center-study-from-india
#4
Sanjay K Agarwal, Dipankar Bhowmik, Sandeep Mahajan, Soumita Bagchi
INTRODUCTION: Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipient (RTR). Immunosuppressive drugs are one of the most important risk factor for post-transplant tuberculosis (PTTB). A paucity of data exists about the impact of the type of calcineurin inhibitor on PTTB. METHODS: In this retrospective study, all adult patients on calcineurin inhibitor-based immunosuppression were included. Patients receiving TB chemoprophylaxis were excluded...
October 24, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27569937/comparative-analysis-of-outcomes-of-kidney-transplantation-in-patients-with-aa-amyloidosis-and-chronic-glomerulonephritis
#5
T Sahutoglu, K Atay, Y Caliskan, E Kara, H Yazici, A Turkmen
BACKGROUND: Amyloid A (AA) amyloidosis is a multisystemic, progressive, and severe disease. Renal involvement is a prominent feature of the disease, and the outcome of patients on dialysis is poor. We aimed to analyze the outcomes of kidney transplantation in patients with AA amyloidosis in comparison with chronic glomerulonephritis (CGN). METHODS: Charts of patients who underwent kidney transplantation between 1988 and 2012 were reviewed; 41 patients with AA amyloidosis were identified, and 41 age- and sex-matched control patients with chronic CGN were included...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27548035/twelve-week-rifapentine-plus-isoniazid-versus-9-month-isoniazid-for-the-treatment-of-latent-tuberculosis-in-renal-transplant-candidates
#6
Jacques Simkins, Lilian Margarita Abbo, Jose Fernando Camargo, Rossana Rosa, Michele Ileana Morris
BACKGROUND: Renal transplant candidates (RTC) with latent tuberculosis infection (LTBI) are at significant risk for tuberculosis reactivation. Twelve-week rifapentine (RPT)/isoniazid (INH) is effective for LTBI but clinical experience in RTC is scarce. METHODS: We conducted a retrospective study of RTC with LTBI treated with either 12-week RPT/INH or 9-month INH from March 1, 2012, through February 28, 2014. We evaluated both groups for differences in rates of treatment completion, monthly follow-up visit compliance, transaminase elevations, and adverse reactions leading to discontinuation of LTBI treatment...
July 12, 2016: Transplantation
https://www.readbyqxmd.com/read/27509589/the-challenges-of-esrd-care-in-developing-economies-sub-saharan-african-opportunities-for-significant-improvement
#7
Ebun Ladipo Bamgboye
Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in sub-Saharan Africa. This, along with other noncommunicable diseases like hypertension, diabetes, and heart diseases, poses a double burden on a region that is still struggling to cope with the scourge of communicable diseases like malaria, tuberculosis, HIV, and more recently Ebola. Causes of CKD in the region are predominantly glomerulonephritis and hypertension, although type 2 diabetes is also becoming a significant cause as is the retroviral disease...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27472705/acute-thrombosis-of-a-transplanted-renal-artery-after-gastric-ulcer-bleeding-in-a-patient-with-a-long-term-well-functioning-renal-allograft-a-case-report-and-literature-review
#8
Chung-Kuan Wu, Jyh-Gang Leu, Cheng-Chun Wei, Shih-Chung Hsieh
BACKGROUND: Acute thrombosis of a transplanted renal artery is a serious vascular complication following renal allograft transplantation, which usually occurs within the first month after transplantation and often results in graft loss. It rarely occurs beyond the first month, except in a rejected kidney or in a kidney with high-grade transplant renal artery stenosis. RESULT: A 65-year-old male with a history of type 2 diabetes mellitus, hypertension, pulmonary tuberculosis, and end-stage renal disease was previously treated with hemodialysis (HD)...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27469157/hiv-associated-renal-disease-an-overview
#9
Nicola Wearne, Ikechi G Okpechi
The cause of the human immunodeficiency virus (HIV) epidemic in South Africa (SA) was worsened by the denial by key political players that HIV causes acquired immunodeficiency syndrome (AIDS). South Africa continues to have the highest rate of HIV world-wide, which has had a huge impact on the development of both chronic kidney disease and acute kidney injury. Fortunately, there is now an effective antiretroviral therapy (ART) roll-out program. SA is also dealing with a collision of epidemics of HIV, tuberculosis, and non-communicable disease, particularly hypertension and diabetes...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27358792/cavitary-lung-lesion-6-years-after-renal-transplantation
#10
Arun Kumar Subbiah, Sudheer Arava, Soumita Bagchi, Karan Madan, Chandan J Das, Sanjay Kumar Agarwal
The differential diagnoses of a cavitary lung lesion in renal transplant recipients would include infection, malignancy and less commonly inflammatory diseases. Bacterial infection, Tuberculosis, Nocardiosis, fungal infections like Aspergillosis and Cryptococcosis need to be considered in these patients. Pulmonary cryptococcosis usually presents 16-21 mo after transplantation, more frequently in patients who have a high level of cumulative immunosuppression. Here we discuss an interesting patient who never received any induction/anti-rejection therapy but developed both BK virus nephropathy as well as severe pulmonary Cryptococcal infection after remaining stable for 6 years after transplantation...
June 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27350740/successful-treatment-of-ileal-ulcers-caused-by-immunosuppressants-in-two-organ-transplant-recipients
#11
Yun-Wei Guo, Hua-Ying Gu, Kodjo-Kunale Abassa, Xian-Yi Lin, Xiu-Qing Wei
Although gastroduodenal ulcers are common in solid organ transplant patients, there are few reports on multiple giant ulcers in the distal ileum and ileocecal valve caused by immunosuppressants Herein, we report on a liver transplant recipient and a renal transplant recipient with multiple large ulcers in the distal ileum and ileocecal valve who rapidly achieved ulcer healing upon withdrawal of sirolimus or tacrolimus and administration of thalidomide. In case 1, a 56-year-old man with primary hepatocellular carcinoma had received a liver transplantation...
June 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27292015/pulmonary-infections-in-immunocompromised-patients-the-role-of-image-guided-fine-needle-aspiration-cytology
#12
S Sharma, P Gupta, N Gupta, A Lal, D Behera, A Rajwanshi
OBJECTIVE: To evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of pulmonary infections in immunocompromised patients and to identify the imaging pattern of infections on computed tomography (CT). MATERIALS AND METHODS: This was a retrospective study of 42 immunocompromised patients who underwent FNAC under image guidance owing to a clinical pulmonary infection. Each patient was evaluated for an underlying immunocompromised condition, cytological diagnosis, CT findings and complications...
June 13, 2016: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/27188439/post-renal-transplant-infections-single-center-experience-from-nigeria
#13
G Iliyasu, A Abdu, F M Dayyab, A B Tiamiyu, Z G Habib, B Adamu, A G Habib
BACKGROUND: Infections are the leading cause of hospitalization and mortality in transplant recipients. Nigeria has a growing number of renal transplant recipients. The aim of this study was to determine the pattern of infections in renal allograft recipients in one of the major renal transplant centers in Nigeria. METHODS: All case records of renal allograft recipients on follow-up were retrieved. Those that had infection at any time after transplantation were selected...
August 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27178832/tuberculosis-and-chronic-kidney-disease-an%C3%A2-emerging-global-syndemic
#14
Kamila Romanowski, Edward G Clark, Adeera Levin, Victoria J Cook, James C Johnston
The link between chronic kidney disease (CKD) and tuberculosis (TB) has been known for more than 40 years, but the interaction between these 2 diseases is still poorly understood. Dialysis and renal transplant patients appear to be at a higher risk of TB, in part related to immunosuppression along with socioeconomic, demographic, and comorbid factors. Meanwhile, TB screening and diagnostic test performance is suboptimal in the CKD population, and there is limited evidence to guide protocols. Given the increasing prevalence of CKD in TB endemic areas, a merging of CKD and TB epidemics could have significant public health implications, especially in low- to middle-income countries such as India and China, that are experiencing rapid increases in CKD prevalence and account for more than one-third of global TB prevalence...
July 2016: Kidney International
https://www.readbyqxmd.com/read/27129535/donor-derived-tuberculosis-in-an-anesthetist-after-short-term-exposure-an-old-demon-transplanted-from-the-past-to-the-present
#15
I Freytag, J Bucher, M Schoenberg, M Stangl, G Schelling
We report a case of a 27-year-old anesthetist who acquired tuberculosis (TB) while performing general anesthesia in a renal transplant (RTX) patient who had donor-derived contagious TB. The anesthetist developed pleural TB 6 months after exposure. Contact investigations (CIs) did not include health care workers (HCWs) of the Department of Anesthesiology, thereby missing the opportunity for the early diagnosis and treatment of TB. Genomic fingerprinting revealed identical Mycobacterium tuberculosis (MT) isolates in the anesthetist and in the RTX patient...
May 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26726960/incidence-of-tuberculosis-is-high-in-chronic-kidney-disease-patients-in-south-east-england-and-drug-resistance-common
#16
Marlies Ostermann, Paramita Palchaudhuri, Alex Riding, Parvin Begum, Heather J Milburn
The risk of tuberculosis (TB) is significantly increased in chronic kidney disease (CKD). Data on TB in CKD in the UK are sparse; most information stems from countries with high background prevalence. The aim of this study was to estimate the incidence of TB in CKD patients in South East London and to describe the epidemiology, treatment, and outcome. CKD patients with TB between 1994 and 2010 were identified retrospectively. Data were collected on type of renal replacement therapy, the method of TB diagnosis, disease site, treatment regimens, and risk factors...
2016: Renal Failure
https://www.readbyqxmd.com/read/26722657/clinical-and-pathological-features-of-kidney-transplant-patients-with-concurrent-polyomavirus-nephropathy-and-rejection-associated-endarteritis
#17
Stephanie M McGregor, W James Chon, Lisa Kim, Anthony Chang, Shane M Meehan
AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy (PVN) and endarteritis due to rejection in renal allografts. METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection (AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis (v1 by Banff criteria)...
December 24, 2015: World Journal of Transplantation
https://www.readbyqxmd.com/read/26614191/risk-of-active-tuberculosis-in-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#18
REVIEW
K Al-Efraij, L Mota, C Lunny, M Schachter, V Cook, J Johnston
BACKGROUND: Although the global prevalence of chronic kidney disease (CKD) is increasing, the relationship between CKD and active TB is not well described. OBJECTIVE: To conduct a systematic review to evaluate active TB risk in CKD populations. METHODS: We searched Ovid Medline, EMBASE and Cochrane databases and relevant journals to identify multicentre or regional studies reporting quantitative effect estimates of an association between CKD and active TB...
December 2015: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/26607644/high-resolution-ct-findings-of-pulmonary-mycobacterium-tuberculosis-infection-in-renal-transplant-recipients
#19
Marisa Pereira, Fernando F Gazzoni, Edson Marchiori, Klaus Irion, Jose Moreira, Irai L Giacomelli, Alessandro Pasqualotto, Bruno Hochhegger
OBJECTIVE: Renal transplantation recipients are at increased risk of Mycobacterium tuberculosis infection because of immunosuppression. The aim of this study was to assess high-resolution CT (HRCT) findings in renal transplantation recipients diagnosed with pulmonary tuberculosis (TB). METHODS: We reviewed HRCT findings from patients diagnosed with pulmonary TB, established by M. tuberculosis detection in bronchoalveolar lavage, sputum or biopsy sample. Two observers independently reviewed HRCT images and reached consensus decisions on the presence and distribution of: (i) miliary nodules, (ii) cavitation and centrilobular tree-in-bud nodules, (iii) ground-glass attenuation and consolidation, (iv) mediastinal lymph node enlargement and (v) pleural effusion...
2016: British Journal of Radiology
https://www.readbyqxmd.com/read/26534762/demographics-and-prevalence-of-positive-quantiferon-tb-gold-in-tube-test-in-renal-transplant-candidates
#20
J Simkins, K Kraus, M I Morris
BACKGROUND: Latent tuberculosis infection (LTBI) screening prior to solid organ transplantation is standard of care. QuantiFERON-TB Gold In-Tube (QFT-GIT) test is the preferred diagnostic test for renal transplant candidates (RTC). QFT-GIT reversions and the potential delay of living-donor kidney transplantation (LDKT) because of QFT-GIT positivity have not been examined previously in RTC. METHODS: We evaluated the prevalence of positive QFT-GIT in RTC from January 1 through December 31, 2011...
February 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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