[Peritoneal tuberculosis and continuous ambulatory peritoneal dialysis].
Depressed immunity in uremic patients increases by ten the risk of tuberculosis. In such patients, 40% of tuberculosis manifestations are extrapulmonary, and peritoneum is involved in about 6% of the cases. Seventeen cases of peritoneal tuberculosis have been so far reported in CAPD patients, and we add a new case. The prognosis of the disease is severe since 8 patients died. Three deaths out of 8 are directly linked to tuberculosis. Indeed, peritoneal tuberculosis diagnosis is hard and often late, at least for two main reasons: at first, it can be difficult to exclude the other causes of lymphocytic peritonitis (viral, fungal, bacterial, etc.), secondly, growth of mycobacteria in dialysate effluent cultures is late and inconstant. Omental biopsy in lymphocytic peritonitis of unknown origin could be of great value for an early diagnosis. Despite the adaptation of antituberculous drugs doses, side-effects are not so rare: optical neuritis and liver toxicity in our case. In spite of ultrafiltration loss, stopping CAPD is not always necessary, as in the reported case.
Mousson
C
C
Service de Néphrologie-Réanimation, Centre Hospitalier Universitaire, Dijon.
Bonnin
A
A
Dumas
M
M
Chevet
D
D
Rifle
G
G
D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis
D000995:Antitubercular Agents
Tuberculose péritonéale et dialyse péritonéale continue ambulatoire.