McWhinney N, Khan O, Williams G
Br J Surg. 1981 Jun;68(6):408-11. doi: 10.1002/bjs.1800680615.
The difficulty in diagnosis of tuberculosis in patients with chronic renal failure or on immunosuppressive therapy is discussed. Anti-tuberculous therapy was required in 19 out of 315 patients who received a renal transplant in the Urology Unit, Hammersmith Hospital, between February 1961 and December 1979. Twelve patients were from overseas. Their management and the effect of anti-tuberculous therapy on the immunosuppressed patient were also studied. The disease was treated successfully in 18 patients, even though there were problems with diagnosis. The patient who died had active tuberculosis on post-morten examination. Prophylaxis should be considered in patients who have had tuberculosis in the past and may have received inadequate treatment.
本文讨论了慢性肾衰竭患者或接受免疫抑制治疗患者的结核病诊断难点。1961年2月至1979年12月期间,在哈默史密斯医院泌尿外科接受肾移植的315名患者中,有19名需要抗结核治疗。其中12名患者来自海外。还研究了他们的治疗情况以及抗结核治疗对免疫抑制患者的影响。尽管诊断存在问题,但18名患者的疾病得到了成功治疗。死亡患者尸检显示患有活动性结核病。对于过去曾患结核病且可能治疗不充分的患者,应考虑进行预防。