title: Tuberculous hepatitis in renal transplant recipients following alemtuzumab induction therapy.
abstract: Mycobacterium tuberculosis infection is one of many opportunistic infections in renal transplant recipients, arising either from reactivation of latent infection or de novo infection, occasionally donor derived. M. tuberculosis hepatitis has never been reported in patients who have received alemtuzumab as part of their renal transplant management. We describe 2 patients who underwent deceased-donor renal transplantation following alemtuzumab induction therapy and presented with a febrile syndrome, subsequently diagnosed as tuberculous hepatitis, one with disseminated disease. Both responded well to treatment without significant side effects, resulting in excellent graft function. The importance of chemoprophylaxis should be emphasized to minimize the risk of developing active tuberculosis in patients with latent tuberculosis infection undergoing solid organ transplantation.
authors.affiliation: Division of Infectious Disease, Mayo Clinic, Jacksonville, Florida 32224, USA.
authors.forename: W
authors.initials: W
authors.lastname: Bosch
authors.forename: N
authors.initials: N
authors.lastname: Poowanawittayakom
authors.forename: K
authors.initials: K
authors.lastname: Chaikriangkrai
authors.forename: J
authors.initials: J
authors.lastname: Mendez
authors.forename: W C
authors.initials: WC
authors.lastname: Hellinger
authors.forename: T A
authors.initials: TA
authors.lastname: Gonwa
authors.forename: M
authors.initials: M
authors.lastname: Krishna
authors.forename: S
authors.initials: S
authors.lastname: Pungpapong
mesh_terms: D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014386:Tuberculosis, Hepatic / Q000188:drug therapy / Q000209:etiology*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab