Tuberculosis dissemination in kidney transplant recipient treated with anti-CD40 monoclonal antibody: a case report

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F22%3A00083317" target="_blank" >RIV/00023001:_____/22:00083317 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/22:10446701 RIV/00064190:_____/22:N0000016

Výsledek na webu

<a href="https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-022-02916-2" target="_blank" >https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-022-02916-2</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1186/s12882-022-02916-2" target="_blank" >10.1186/s12882-022-02916-2</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Tuberculosis dissemination in kidney transplant recipient treated with anti-CD40 monoclonal antibody: a case report

Popis výsledku v původním jazyce

Background Tuberculosis (TBC) in solid organ transplant recipients represents a severe complication. The incidence among transplant recipients is higher than in the general population, and the diagnosis and treatment remain challenging. We present a case of active disseminated tuberculosis in a kidney transplant recipient treated with an anti-CD40 monoclonal antibody, who had been previously exposed to an active form of the disease, but latent tuberculosis (LTBI) was repeatedly ruled out prior to transplantation. To the best of our knowledge, no other case has been reported in a patient treated with the anti-CD40 monoclonal antibody. Case presentation A 49-year-old patient, 1.5 years after primary kidney transplantation, presented with vocal cord problems, a dry irritating cough, and a sore throat. A detailed investigation, including a high-resolution chest CT scan, revealed the diagnosis of disseminated tuberculosis. The antituberculosis treatment consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol was started immediately. The patient&apos;s condition became complicated by relapsing diarrhoea. The colonoscopy revealed a circular stenosis above Bauhin&apos;s valve. Microscopical findings showed active colitis and vaguely formed collections of epithelioid macrophages without fully developed caseous granulomas and were consistent with the clinical diagnosis of tuberculosis. The antituberculosis treatment was subsequently enhanced by moxifloxacin and led to a great improvement in the patient&apos;s condition. Conclusion In this case, false negativity of interferon-gamma release assays and possibly higher risk for intracellular infections in patients on costimulatory signal blockers are discussed.

Název v anglickém jazyce

Tuberculosis dissemination in kidney transplant recipient treated with anti-CD40 monoclonal antibody: a case report

Popis výsledku anglicky

Background Tuberculosis (TBC) in solid organ transplant recipients represents a severe complication. The incidence among transplant recipients is higher than in the general population, and the diagnosis and treatment remain challenging. We present a case of active disseminated tuberculosis in a kidney transplant recipient treated with an anti-CD40 monoclonal antibody, who had been previously exposed to an active form of the disease, but latent tuberculosis (LTBI) was repeatedly ruled out prior to transplantation. To the best of our knowledge, no other case has been reported in a patient treated with the anti-CD40 monoclonal antibody. Case presentation A 49-year-old patient, 1.5 years after primary kidney transplantation, presented with vocal cord problems, a dry irritating cough, and a sore throat. A detailed investigation, including a high-resolution chest CT scan, revealed the diagnosis of disseminated tuberculosis. The antituberculosis treatment consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol was started immediately. The patient&apos;s condition became complicated by relapsing diarrhoea. The colonoscopy revealed a circular stenosis above Bauhin&apos;s valve. Microscopical findings showed active colitis and vaguely formed collections of epithelioid macrophages without fully developed caseous granulomas and were consistent with the clinical diagnosis of tuberculosis. The antituberculosis treatment was subsequently enhanced by moxifloxacin and led to a great improvement in the patient&apos;s condition. Conclusion In this case, false negativity of interferon-gamma release assays and possibly higher risk for intracellular infections in patients on costimulatory signal blockers are discussed.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

BMC nephrology [online]

ISSN

1471-2369

e-ISSN

1471-2369

Svazek periodika

23

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

6

Strana od-do

"art. no. 290"

Kód UT WoS článku

000842034300001

EID výsledku v databázi Scopus

2-s2.0-85136961989