Tsevi Mawufemo Yawovi, Sabi Akomola Kossi, Lawson-Ananissoh Laté Mawuli, Noto-Kadou-Kaza Befa, Amekoudi Eyram Yoan
Service de néphrologie et d'hémodialyse, CHU Sylvanus-Olympio, BP 14148, Lomé, Togo.
Service de néphrologie et d'hémodialyse, CHU Sylvanus-Olympio, BP 14148, Lomé, Togo.
Nephrol Ther. 2017 Feb;13(1):14-17. doi: 10.1016/j.nephro.2016.07.447. Epub 2016 Nov 11.
To determine the frequency of tuberculosis among hemodialysis patients in Togo, specify its different localizations and identify its diagnostic and therapeutic difficulties.
This was a retrospective study over a period of 5 years (2010-2015). It includes the records of periodic hemodialysis patients in the Nephrology Department of the Sylvanus-Olympio University Teaching Hospital in Lomé. The diagnosis of tuberculosis was selected on the basis of clinical and laboratory data. The specific treatment has involved the association of 4 antituberculosis, which was adapted to the renal function.
Of 91 chronic hemodialysis patients treated in Hospital Sylvanus-Olympio hemodialysis center, 10 cases (10.9%) of tuberculosis were diagnosed. The mean age was 37.3±12.8 years, and the sex ratio was 1.5. The median time to onset of tuberculosis after initiation of hemodialysis was 16.8±9 months. Extrapulmonary sites are found in 100% of cases (5 had both peritoneal and pleural localization, only 5 had pleural localization). The tuberculin skin test was positive in 4 patients (40%). The search for Mycobacterium tuberculosis was unsuccessful in all types of samples. Tuberculosis treatment was generally tolerated. Two patients (20%) had died during treatment.
Tuberculosis is relatively common in hemodialysis patients. Diagnosis is difficult and may be based on the therapeutic trial.
确定多哥血液透析患者中结核病的发病率,明确其不同的发病部位,并找出其诊断和治疗方面的难点。
这是一项为期5年(2010 - 2015年)的回顾性研究。研究对象包括洛美市西尔瓦努斯 - 奥林匹奥大学教学医院肾病科定期进行血液透析的患者记录。结核病的诊断基于临床和实验室数据。具体治疗采用了4种抗结核药物联合使用的方案,并根据肾功能进行了调整。
在西尔瓦努斯 - 奥林匹奥医院血液透析中心接受治疗的91例慢性血液透析患者中,诊断出10例(10.9%)结核病患者。平均年龄为37.3±12.8岁,男女比例为1.5。血液透析开始后结核病发病的中位时间为16.8±9个月。100%的病例为肺外发病部位(5例同时有腹膜和胸膜发病,仅5例有胸膜发病)。4例患者(40%)结核菌素皮肤试验呈阳性。在所有类型的样本中均未成功检测到结核分枝杆菌。结核病治疗总体上耐受性良好。2例患者(20%)在治疗期间死亡。
结核病在血液透析患者中相对常见。诊断困难,可能需基于治疗性试验。