İrem Pembegül YİĞİT, Hülya TAŞKAPAN, ALİ GÜREL

Extrapulmonary tuberculosis in ten hemodialysis patients: a single center experience

Tuberculosis (TB) infection is increasing all over the world especially among immunocompromised patients including end stage renal disease (ESRD) patients. Symptoms and signs are non-spesific and involvement is generally extra-pulmonary in ESRD patients. We presented ten ESRD patients with TB. Six of our cases presented with TB lymphadenitis, two with Pott's disease, one with breast TB and one with lung TB and Wegener's granulomatosis. The diagnosis of TB is based on the finding of an acid fast bacilli-positive smear, positive culture of Mycobacterium tuberculosis, and typical histopathologic findings. Anti-TB therapy with isoniazid, rifampin, pyrazinamide and ethambutol combinations are generally successful. Non- spesific constitutional symptoms and unexplained deterioration of general health in ESRD patients should attract attention of clinicians about TB infections

PDF

___

Dye C. Global of tuberculosis. Lancet. 2006;367(9514):938-40.

Abdelrahman M, Sinha AK, Karkar A. Tuberculosis in end-stage renal disease 2006;10(4):360-4. Hemodial Int. maintenance dialysis patients. Nephron.

Polley P, Dunn R. Noncontiguous spinal tuberculosis: incidence and management. Eur Spine J. 2009; 18(8):1096-101.

Fuentes Ferrer M, Gutiérrez Torres L, Ayala Ramírez O, Rumayor Zarzuelo M, del Prado González N. Tuberculosis of the spine. A systematic review of case series. Int Orthop. 2012;36(2):221-31.

Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS. Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med. 1992;116(6):488-98.

Niles JL, Bottinger EP, Saurina GR, Kelly KJ, Pan G, Collins AB, McCluskey RT. The syndrome of lung hemorrhage and nephritis is usually an ANCA-associated condition. Arch Intern Med. 1996;156(4):440-5.

Pradhan VD, Badakere SS, Ghosh K, Pawar AR. Spectrum of anti- neutrophil cytoplasmic antibodies in patients with pulmonary tuberculosis overlaps with that of Wegener's granulomatosis. Indian J Med Sci. 2004;58(7):2838.

Flores-Suarez LF, Cabiedes J, Villa AR, van der Woude FJ, Alcocer-Varela J. Prevalence of antineutrophil cytoplasmic autoantibodies in patients with tuberculosis. Rheumatology (Oxford). 2003;42(2):223-9.

Lima I, Oliveira RC, Cabral MS, Atta A, Marchi S, Reis E, Reis MG, Barbosa L, Santiago MB. Anti-PR3 and anti-MPO antibodies are not present in sera of patients with pulmonary tuberculosis. Rheumatol Int. 2014;34(9):1231-4.

Shankar MS, Aravindan AN, Sohal PM, Kohli HS, Sud K, Gupta KL, Sakhuja V, Jha V. The prevalence of tuberculin sensitivity and anergy in chronic renal failure in an endemic area: Tuberculin test and the risk of post-transplant tuberculosis. Nephrol Dial Transplant. 2005;20(12):2720-4.

Milburn HJ.How should we treat tuberculosis in adult patients with chronic kidney disease? Key messages from the British Thoracic 2010;120(10):417-22. Pol Arch Med Wewn.