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以终末期肾病为重点的泌尿生殖系统结核综述。

Review of genitourinary tuberculosis with focus on end-stage renal disease.

作者信息

Lima Neiberg A, Vasconcelos Carol C, Filgueira Pedro Henrique O, Kretzmann Meissa, Sindeaux Ticiano A S, Feitosa Neto Beni, Silva Junior Geraldo B, Daher Elizabeth F

机构信息

Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2012 Jan-Feb;54(1):57-60. doi: 10.1590/s0036-46652012000100011.

Abstract

Tuberculosis (TB) is a current public health problem, remaining the most common worldwide cause of mortality from infectious disease. Recent studies indicate that genitourinary TB is the third most common form of extra-pulmonary disease. The diagnosis of renal TB can be hypothesized in a non-specific bacterial cystitis associated with a therapeutic failure or a urinalysis with a persistent leukocyturia in the absence of bacteriuria. We report on the case of a 33-year-old man who presented on admission end stage renal disease (ESRD) secondary to renal TB and a past history of pulmonary TB with important radiologic findings. The diagnosis was based on clinical findings despite all cultures being negative. Empiric treatment with tuberculostatic drugs was started and the patient became stable. He was discharged with no symptom, but without renal function recovery. He is on maintenance hemodialysis three times a week. TB is an important cause of kidney disease and can lead to irreversible renal function loss.

摘要

结核病(TB)是当前的一个公共卫生问题,仍然是全球范围内传染病致死的最常见原因。近期研究表明,泌尿生殖系统结核是肺外疾病的第三大常见形式。肾结核的诊断可基于与治疗失败相关的非特异性细菌性膀胱炎,或在无细菌尿的情况下持续存在白细胞尿的尿液分析来推测。我们报告了一例33岁男性病例,该患者入院时因肾结核继发终末期肾病(ESRD),并有肺结核病史及重要的影像学表现。尽管所有培养结果均为阴性,但诊断仍基于临床发现。开始使用抗结核药物进行经验性治疗,患者病情稳定。他出院时无症状,但肾功能未恢复。他每周进行三次维持性血液透析。结核病是肾病的一个重要原因,可导致不可逆转的肾功能丧失。

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