PMID- 35986231
OWN - NLM
STAT- MEDLINE
DCOM- 20220823
LR  - 20220906
IS  - 1471-2369 (Electronic)
IS  - 1471-2369 (Linking)
VI  - 23
IP  - 1
DP  - 2022 Aug 19
TI  - Tuberculosis dissemination in kidney transplant recipient treated with anti-CD40 
      monoclonal antibody: a case report.
PG  - 290
LID - 10.1186/s12882-022-02916-2 [doi]
LID - 290
AB  - BACKGROUND: Tuberculosis (TBC) in solid organ transplant recipients represents a 
      severe complication. The incidence among transplant recipients is higher than in 
      the general population, and the diagnosis and treatment remain challenging. We 
      present a case of active disseminated tuberculosis in a kidney transplant 
      recipient treated with an anti-CD40 monoclonal antibody, who had been previously 
      exposed to an active form of the disease, but latent tuberculosis (LTBI) was 
      repeatedly ruled out prior to transplantation. To the best of our knowledge, no 
      other case has been reported in a patient treated with the anti-CD40 monoclonal 
      antibody. CASE PRESENTATION: A 49-year-old patient, 1.5 years after primary 
      kidney transplantation, presented with vocal cord problems, a dry irritating 
      cough, and a sore throat. A detailed investigation, including a high-resolution 
      chest CT scan, revealed the diagnosis of disseminated tuberculosis. The 
      antituberculosis treatment consisting of rifampicin, isoniazid, pyrazinamide, and 
      ethambutol was started immediately. The patient's condition became complicated by 
      relapsing diarrhoea. The colonoscopy revealed a circular stenosis above Bauhin's 
      valve. Microscopical findings showed active colitis and vaguely formed 
      collections of epithelioid macrophages without fully developed caseous granulomas 
      and were consistent with the clinical diagnosis of tuberculosis. The 
      antituberculosis treatment was subsequently enhanced by moxifloxacin and led to a 
      great improvement in the patient's condition. CONCLUSION: In this case, false 
      negativity of interferon-gamma release assays and possibly higher risk for 
      intracellular infections in patients on costimulatory signal blockers are 
      discussed.
CI  - (c) 2022. The Author(s).
FAU - Bednarova, Kamila
AU  - Bednarova K
AD  - Department of Nephrology, Transplant Center, Institute for Clinical and 
      Experimental Medicine, Videnska 1958/9, 14021, Prague, Czech Republic.
AD  - 1St Medical Faculty, Charles University, Prague, Czech Republic.
FAU - Slatinska, Janka
AU  - Slatinska J
AD  - Department of Nephrology, Transplant Center, Institute for Clinical and 
      Experimental Medicine, Videnska 1958/9, 14021, Prague, Czech Republic.
FAU - Fabian, Ondrej
AU  - Fabian O
AD  - Clinical and Transplant Pathology Centre, Institute for Clinical and Experimental 
      Medicine, Prague, Czech Republic.
FAU - Wohl, Pavel
AU  - Wohl P
AD  - Department of Hepatogastroenterology, Transplant Centre, Institute for Clinical 
      and Experimental Medicine, Prague, Czech Republic.
FAU - Kopecka, Emilia
AU  - Kopecka E
AD  - Department of Respiratory Medicine, 1St Faculty of Medicine of Charles University 
      and Thomayer Hospital, Prague, Czech Republic.
FAU - Viklicky, Ondrej
AU  - Viklicky O
AD  - Department of Nephrology, Transplant Center, Institute for Clinical and 
      Experimental Medicine, Videnska 1958/9, 14021, Prague, Czech Republic. 
      ondrej.viklicky@ikem.cz.
AD  - Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, 
      Czech Republic. ondrej.viklicky@ikem.cz.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220819
PL  - England
TA  - BMC Nephrol
JT  - BMC nephrology
JID - 100967793
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Antibodies, Monoclonal/therapeutic use
MH  - *Antineoplastic Agents
MH  - Antitubercular Agents/therapeutic use
MH  - Humans
MH  - *Kidney Transplantation/adverse effects
MH  - Middle Aged
MH  - Transplant Recipients
MH  - *Tuberculosis/diagnosis/drug therapy/epidemiology
PMC - PMC9388963
OTO - NOTNLM
OT  - Case report
OT  - Costimulation
OT  - Iscalimab
OT  - Kidney transplantation
OT  - Tuberculosis
COIS- The authors have no conflicts of interest to declare.
EDAT- 2022/08/20 06:00
MHDA- 2022/08/24 06:00
PMCR- 2022/08/19
CRDT- 2022/08/19 23:30
PHST- 2022/03/17 00:00 [received]
PHST- 2022/08/12 00:00 [accepted]
PHST- 2022/08/19 23:30 [entrez]
PHST- 2022/08/20 06:00 [pubmed]
PHST- 2022/08/24 06:00 [medline]
PHST- 2022/08/19 00:00 [pmc-release]
AID - 10.1186/s12882-022-02916-2 [pii]
AID - 2916 [pii]
AID - 10.1186/s12882-022-02916-2 [doi]
PST - epublish
SO  - BMC Nephrol. 2022 Aug 19;23(1):290. doi: 10.1186/s12882-022-02916-2.