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肾移植受者活动性肺结核的放射学表现:4例回顾性研究及文献复习

Radiological presentation of active pulmonary tuberculosis in kidney transplant recipients: a retrospective study of four cases and a review of the literature.

作者信息

Oliveira Virgilio de Araujo, Almeida Ricardo Augusto Monteiro de Barros, Cavalcante Ricardo de Souza, de Andrade Luis Gustavo Modelli, Ribeiro Sergio Marrone

机构信息

Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP). Botucatu, SP, Brazil.

出版信息

Radiol Bras. 2024 May 7;57:e20230124. doi: 10.1590/0100-3984.2023.0124. eCollection 2024 Jan-Dec.

Abstract

Although kidney transplantation is the best therapeutic option for patients with chronic kidney disease, the immunosuppression required greatly increases susceptibility to infections that are responsible for high post-transplant mortality. Pulmonary tuberculosis (TB) represents a major cause of such infections, and its early diagnosis is therefore quite important. In view of that, we researched the manifestations of active pulmonary TB in kidney transplant recipients, through chest X-ray and computed tomography (CT), as well as determining the number of cases of active pulmonary TB occurring over a 3.5-year period at our institution. We identified four cases of active pulmonary TB in kidney transplant recipients. The CT scans provided information complementary to the chest X-ray findings in all four of those cases. We compared our CT findings with those reported in the literature. We analyzed our experience in conjunction with an extensive review of the literature that was nevertheless limited because few studies have been carried out in lowand middle-income countries, where the incidence of TB is higher.

摘要

尽管肾移植是慢性肾病患者的最佳治疗选择,但所需的免疫抑制会大大增加感染易感性,而感染是移植后高死亡率的原因。肺结核(TB)是此类感染的主要原因,因此其早期诊断非常重要。有鉴于此,我们通过胸部X光和计算机断层扫描(CT)研究了肾移植受者活动性肺结核的表现,并确定了我院3.5年期间发生的活动性肺结核病例数。我们在肾移植受者中发现了4例活动性肺结核病例。在所有这4例病例中,CT扫描提供了与胸部X光检查结果互补的信息。我们将我们的CT检查结果与文献报道的结果进行了比较。我们结合对文献的广泛回顾分析了我们的经验,不过文献回顾有限,因为在结核病发病率较高的低收入和中等收入国家开展的研究很少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cf/11235070/b25adeaf2629/rb-57-e20230124-g01.jpg

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