PMID- 22279345
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20211021
IS  - 1998-3662 (Electronic)
IS  - 0971-4065 (Print)
IS  - 0971-4065 (Linking)
VI  - 22
IP  - 1
DP  - 2012 Jan
TI  - Tuberculosis in a renal allograft recipient presenting with intussusception.
PG  - 52-6
LID - 10.4103/0971-4065.83741 [doi]
AB  - Extra-pulmonary tuberculosis (TB) is more common in renal allograft recipients 
      and may present with dissemination or an atypical features. We report a renal 
      allograft recipient with intestinal TB presenting 3 years after transplantation 
      with persistent fever, weight loss, diarrhea, abdominal pain and mass in the 
      abdomen with intestinal obstruction. He was diagnosed to be having an ileocolic 
      intussusception which on resection showed a granulomatous inflammation with 
      presence of acid-fast bacilli (AFB) typical of Mycobacterium tuberculosis. In 
      addition, AFB was detected in the tracheal aspirate, indicating dissemination. He 
      received anti-TB therapy (ATT) from the fourth postoperative day. However, he 
      developed a probable immune reconstitution inflammatory syndrome (IRIS) with 
      multiorgan failure and died on 11(th) postoperative day. This is the first report 
      of intestinal TB presenting as intussusception in a renal allograft recipient. 
      The development of IRIS after starting ATT is rare in renal allograft recipients. 
      This report highlights the need for a high index of suspicion for diagnosing TB 
      early among renal transplant recipients and the therapeutic dilemma with 
      overwhelming infection and development of IRIS upon reduction of 
      immunosuppression and starting ATT.
FAU - Mohapatra, A
AU  - Mohapatra A
AD  - Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
FAU - Basu, G
AU  - Basu G
FAU - Sen, I
AU  - Sen I
FAU - Asirvatham, R
AU  - Asirvatham R
FAU - Michael, J S
AU  - Michael JS
FAU - Pulimood, A B
AU  - Pulimood AB
FAU - John, G T
AU  - John GT
LA  - eng
PT  - Case Reports
PL  - India
TA  - Indian J Nephrol
JT  - Indian journal of nephrology
JID - 8914356
PMC - PMC3263066
OTO - NOTNLM
OT  - Immune reconstitution inflammatory syndrome
OT  - intussusception
OT  - kidney transplantation
OT  - renal allograft recipient
OT  - tuberculosis
COIS- Conflict of Interest: None declared.
EDAT- 2012/01/27 06:00
MHDA- 2012/01/27 06:01
PMCR- 2012/01/01
CRDT- 2012/01/27 06:00
PHST- 2012/01/27 06:00 [entrez]
PHST- 2012/01/27 06:00 [pubmed]
PHST- 2012/01/27 06:01 [medline]
PHST- 2012/01/01 00:00 [pmc-release]
AID - IJN-22-52 [pii]
AID - 10.4103/0971-4065.83741 [doi]
PST - ppublish
SO  - Indian J Nephrol. 2012 Jan;22(1):52-6. doi: 10.4103/0971-4065.83741.