Laryngeal tuberculosis in renal allograft patients.
Laryngeal tuberculosis, although the most common granulomatous disease of the larynx, is a rare form of extrapulmonary tuberculosis, never reported in immunosuppressed allograft recipients. We present two cases of laryngeal tuberculosis in renal transplant patients and a review of the literature. Two women, a 29-year-old and a 60-year-old, each more than 9 years after their cadaveric renal allograft, presented with a 2-week febrile illness with hoarseness and dysphagia, and both were found to have laryngeal tuberculosis by direct laryngoscopy. Although both radiographs were unremarkable, both patients had sputum positive for acid-fast bacilli that subsequently grew Mycobacterium tuberculosis. Clinical response promptly followed institution of isoniazid, rifampicin, and pyrazinamide in each case, although both required threefold increases in daily cyclosporin A dosage to maintain therapeutic levels.
Tato
A M
AM
Servicio de Nefrología, Hospital Ramón y Cajal, Madrid, Spain.
Pascual
J
J
Orofino
L
L
Fernández-Juárez
G
G
Martínez-San-Millán
J
J
Fogué
L
L
Liaño
F
F
Ortuño
J
J
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D013997:Time Factors; D014184:Transplantation, Homologous; D014387:Tuberculosis, Laryngeal / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
D000995:Antitubercular Agents