Tuberculous ileitis in a renal transplant recipient with familial Mediterranean fever: Gray-scale and power Doppler sonographic findings.
The ileocecal area is the most common site of involvement of intestinal tuberculosis. We report the case of a 26-year-old renal transplant recipient with familial Mediterranean fever who developed tuberculous ileitis. Gray-scale sonography and CT showed circumferential thickening of the bowel wall and enlargement of the mesenteric lymph nodes. Power Doppler sonography revealed markedly increased vascularity in the wall of the affected ileal segment and in the mesenteric nodes. Some nodes had no flow at the center owing to caseation necrosis, a finding consistent with the diagnosis of tuberculous ileitis. Colonoscopy was performed, and histopathologic examination of biopsy specimens revealed acute inflammatory changes. Cultures of the specimens confirmed the presence of Mycobacterium tuberculosis. We conclude that findings on power Doppler sonography may support a diagnosis of tuberculous ileitis and avoid clinical mismanagement.
Yilmaz
Erkan
E
Department of Radiology, Dokuz Eylül University School of Medicine, Inciralti, 35340 Izmir, Turkey.
Balci
Ali
A
Sal
Selma
S
Cakmakci
Handan
H
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D010505:Familial Mediterranean Fever / Q000150:complications*; D005260:Female; D006801:Humans; D007079:Ileitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D016030:Kidney Transplantation; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018608:Ultrasonography, Doppler
D000995:Antitubercular Agents