Tuberculosis in renal transplant recipients: rifampicin sparing treatment protocol.
The reactivation of mycobacterium infection in renal transplant recipients in developing countries is a common therapeutic dilemma, especially in those patients receiving cyclosporin immunosuppression. The inclusion of rifampicin in the antituberculosis protocol increases the risk of precipitating acute allograft rejection due to its interaction with cyclosporin and also increases the financial burden. We successfully treated 16 patients who developed mycobacterial infection post renal transplant with a rifampicin sparing antituberculosis drug regimen. Pyrexia of unknown origin was the most common manifestation observed and a therapeutic trial with antituberculosis drugs is justified. De novo diabetes mellitus appears to be an added risk factor and increases the susceptibility to mycobacterial infection.
Department of Transplantation, Bombay Hospital Institute of Medical Sciences, Mumbai, India. Tushar.Vachharajani@med.va.gov
Tushar J
TJ
Vachharajani
Umesh G
UG
Oza
Ajit G
AG
Phadke
Ashok L
AL
Kirpalani
D000328:Adult; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use; D003906:Developing Countries; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007194:India; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D012293:Rifampin; D014376:Tuberculosis / Q000188:drug therapy* / Q000276:immunology
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D012293:Rifampin