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Tuberculosis isolated to the renal allograft
I Lorimer1, J Botha, A R Pontin
1Department of Surgery, University of Cape Town, Cape Town, South Africa.
Summary
Tuberculosis isolated to the renal allograft can cause graft dysfunction in transplant recipients. Prompt anti-tuberculous therapy may successfully salvage kidney allograft function.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Immunology
Background:
- Renal transplant recipients on immunosuppression face heightened risks of infections, including tuberculosis.
- Tuberculosis (TB) can manifest in various forms, posing diagnostic challenges in immunocompromised individuals.
Observation:
- This study details four cases of renal transplant patients presenting with tuberculosis confined to the renal allograft.
- Symptoms, including febrile illness, appeared 12-26 months post-transplant in three patients.
- Diagnosis was confirmed via graft nephrectomy or percutaneous biopsy.
Findings:
- Tuberculosis was the sole site of infection in all described cases.
- One patient with renal allograft dysfunction recovered function after successful anti-TB treatment.
- No evidence of disseminated tuberculosis was found in any patient.
Implications:
- Isolated renal allograft tuberculosis is a potential cause of graft dysfunction, particularly in TB-endemic regions.
- Early diagnosis and appropriate anti-tuberculous therapy can lead to successful kidney allograft salvage.
- Highlights the importance of considering TB in renal transplant patients with unexplained graft dysfunction.