Wang Wei, Wang An-sheng, Wang Zhong-yuan, Wang Jin-he, Lin Ming-gui, Zhang Tao, Li Jing, An Hui-ru, Li Yan-feng
Research Institute of Tuberculosis of Secondary Affiliated Hospital, PLA General Hospital, Beijing 100091, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Feb;30(2):124-6.
To describe the clinical features, diagnosis and treatment of tuberculosis after organ transplantation.
The clinical data of 25 cases of tuberculosis after organ transplantation were retrospectively analyzed.
Sixty-eight percent of the patients presented only mild symptoms. Fever, cough, malaise and chest tightness were among the most common manifestations. Pulmonary tuberculosis, pleurisy, miliary lesions, lymph node disease, and kidney tuberculosis were common. Involvement of two organs were present in 72% (18/25) of the patients. Radiology showed soft lesions, miliary nodules, pleural effusion, hilar and mediastinal lymphadenopathy. Bacteriology and histology were used to confirm the diagnosis in most cases. The average time from presentation to diagnosis was 38 d. The effective rate of therapy was 76% (19/25).
More attention should be paid to tuberculosis after organ transplantation and immunosuppression. Prompt diagnosis and treatment are important measures to reduce the mortality.
描述器官移植后结核病的临床特征、诊断及治疗。
回顾性分析25例器官移植后结核病患者的临床资料。
68%的患者仅表现为轻微症状。发热、咳嗽、乏力及胸闷是最常见的表现。肺结核、胸膜炎、粟粒性病变、淋巴结疾病及肾结核较为常见。72%（18/25）的患者有两个器官受累。影像学表现为软组织病变、粟粒结节、胸腔积液、肺门及纵隔淋巴结肿大。多数病例通过细菌学和组织学确诊。从出现症状到确诊的平均时间为38天。治疗有效率为76%（19/25）。
应更加关注器官移植及免疫抑制后的结核病。及时诊断和治疗是降低死亡率的重要措施。
