Early diagnosis, treatment and prevention of tuberculosis following kidney transplantation / 中华健康管理学杂志

ABSTRACT

Objective To establish early diagnosis,treatment and prevention of tuberculosis infection following kidney transplantation.Methods Eighteen post-operative tuberculosis infections were identified among 1024 kidney transplantations performed in Beijing Chaoyang Hospital between January 2002 and December 2009.Triple immunosuppressive therapy strategy was used for these 18 patients.Of the 14 patients who received immune induction therapy,4 were treated with monoclonal antibody,and the other 10 were treated with anti-thymocyte globulin(ATG)or anti-lymphocyte globulin(ALG).Results The interval between renal transplantation and identification of tuberculosis infection ranged from 1 to 54 months.Posttransplant tuberculosis infection showed no typical clinical manifestations at early stage.Persistent or intermittent fever was the main symptom.High resolution CT and bronchoalveolar lavage fluid(BALF)test were useful tools for confirmed diagnosis.After routine anti-tuberculosis treatment,17 patients were cured and 1 patient died.Conclusions The early stage symptoms of post-transplant tuberculosis may be atypical,which could result in misdiagnosis.Pulmonary high-resolution CT examination and BALF test could provide strong evidence for tuberculosis infection.