The use of cyclosporine modifies the clinical and histopathological presentation of tuberculosis after renal transplantation
Rev. Inst. Med. Trop. Säo Paulo
;
42(4): 225-30, July-Aug. 2000. tab
Artigo
em Inglês
| LILACS
| ID: lil-266056
RESUMO
Tuberculosis is one of the most frequent opportunistic infections after renal transplantation and occurred in 30 of 1264 patients transplanted between 1976 and 1996 at Hospital São Paulo - UNIFESP and Hospital Dom Silvério, Brazil. The incidence of 2.4 per cent is five times higher than the Brazilian general population. The disease occurred between 50 days to 18 years after the transplant, and had an earlier and worse development in patients receiving azathioprine, prednisone and cyclosporine, with 35 per cent presenting as a disseminated disease, while all patients receiving azathioprine and prednisone had exclusively pulmonary disease. Ninety percent of those patients had fever as the major initial clinical manifestation. Diagnosis was made by biopsy of the lesion (50 per cent), positivity to M. tuberculosis in the sputum (30 per cent) and spinal cerebral fluid analysis (7 per cent). Duration of treatment ranged from 6 to 13 months and hepatotoxicity occurred in 3 patients. The patients who died had a significant greater number of rejection episodes and received higher doses of corticosteroid. In conclusion, the administration of cyclosporine changed the clinical and histopathological pattern of tuberculosis occurring after renal transplantation.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Tuberculose
/
Transplante de Rim
/
Ciclosporina
/
Imunossupressores
Tipo de estudo:
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Rev. Inst. Med. Trop. Säo Paulo
Assunto da revista:
Medicina Tropical
Ano de publicação:
2000
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade Federal de São Paulo/BR
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