RESUMO
AIM: To study the incidence, pattern of tuberculosis, Its risk factors, and prognosis in renal transplantation recipients in Indian population. SETTINGS AND DESIGN: This study retrospectively analyzed the patients who underwent renal transplantation at Ramaiah medical college Hospitals, India from 2004 to 2015. METHODS AND MATERIAL: The study enrolled 244 patients. Diagnosis was based on radio0imaging, sputum smear, culture and polymerase chainreaction and histology. STATISTICAL ANALYSIS USED: A descriptive univariate analysis was performed to identify the individual risk factors. RESULTS: The TB infection was present in 21/244 (8.6%) renal transplantation patients (mean age ± SD = 44.3 ± 12.9 years). Pulmonary tuberculosis was the commonest (57%) followed by extrapulmonary tuberculosis (43%). Type II diabetes mellitus (DM) (14.6%; p = 0.0169)was significant risk factor. Majority of the patients (n = 18, 10.7%) were on standard tripledrug immunosuppression. The median duration of anti0tubercular therapy was 14 months and crude mortality was 19%. CONCLUSIONS: High index of suspicion for tuberculosis is require d in renal transplant recipients owing to their immunocompromised status and atypical presentations. Higher age, DM and use of immunosuppressants increase the risk for post0renal transplantation tuberculosis. Interactions between anti0tubercular drugs and immunosuppressants need to be considered in these patients.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Rejeição de Enxerto/prevenção & controle , Imunossupressores/uso terapêutico , Falência Renal Crônica/cirurgia , Transplante de Rim , Tuberculose Pulmonar/epidemiologia , Adulto , Distribuição por Idade , Antituberculosos/uso terapêutico , Feminino , Humanos , Hospedeiro Imunocomprometido , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Tuberculose/imunologia , Tuberculose/mortalidade , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/mortalidadeRESUMO
Lymphadenopathy can be caused by localized and systemic diseases. While viral and bacterial infections commonly cause lymphadenitis in young adults, tuberculosis (TB) is a common cause for lymphadenopathy in endemic areas. Besides, lymphadenopathy may be a presenting manifestation of malignancy, systemic disorders and some rare diseases. Thus, relevant evaluation and exclusion of commoner causes is important to clinch the diagnosis. Histopathological examination is mandatory in such patients. We hereby report the case of a young adult male who presented with low-grade fever and abdominal pain with cervical and mesenteric lymphadenopathy in a TB endemic region, but was proved to have atypical presentation of Kikuchi-Fujimoto disease, which is a rare but benign cause of lymphadenopathy.