scholarly journals The first report of co-existence of pulmonary tuberculosis and lung malignancy in a kidney transplant recipient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gang Fang ◽  
Ning-Chang Cheng ◽  
Li-Li Huang ◽  
Wei-Ping Xie ◽  
Chun-Mei Hu ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Pulmonary Tuberculosis ◽  
Lung Adenocarcinoma ◽  
Kidney Transplant ◽  
Fdg Pet ◽  
Lower Lobe ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Transplant Patients ◽  
Clinical Awareness

Abstract Background Along with the medical development, organ transplant patients increase dramatically. Since these transplant patients take immunosuppressants for a long term, their immune functions are in a suppressed state, prone to all kinds of opportunistic infections and cancer. However, it is rarely reported that the kidney transplant recipients (KTRs) have pulmonary tuberculosis and lung cancer simultaneously. Case presentation A 60-year-old male was admitted because of persistent lung shadow for 2 years without any obvious symptom 8 years after renal transplant. T-SPOT test was positive but other etiological examinations for Mycobacterium tuberculosis were negative. Chest CT scan revealed two pulmonary lesions in the right upper and lower lobe respectively. 18F-fluorodesoxyglucose positron-emission tomography (FDG-PET) CT found FDG intake increased in both pulmonary consolidation lesions. CT-guided percutaneous transthoracic needle biopsy revealed lung adenocarcinoma and tuberculosis. The video-assisted thoracoscopic surgery was operated to resect the malignancy lesions. The patient received specific anti-tuberculosis therapy and was discharged. At the follow-up of 6 months post drug withdrawal, the patient was recovered very well. Conclusions We for the first time reported co-existence of smear-negative pulmonary TB and lung adenocarcinoma in a KTR, which highlighted the clinical awareness of co-occurrence of TB and malignancy after renal transplant and emphasized the value of biopsy and 18F-FDG-PET in early diagnosis of TB and cancer.

scholarly journals The first report of co-existence of pulmonary tuberculosis and lung malignancy in a kidney transplant recipient. A case report and literature review

2021 ◽  
Author(s):  
Gang Fang ◽  
Ning-Chang Cheng ◽  
Li-Li Huang ◽  
Wei-Ping Xie ◽  
Chun-Mei Hu ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Pulmonary Tuberculosis ◽  
Lung Adenocarcinoma ◽  
Kidney Transplant ◽  
Fdg Pet ◽  
Kidney Transplant Recipient ◽  
Transthoracic Needle Biopsy ◽  
Transplant Patients ◽  
Clinical Awareness

Abstract Background Along with the medical development, organ transplant patients increase dramatically. Since these transplant patients take immunosuppressants for a long term, their immune functions are in a suppressed state, prone to all kinds of opportunistic infections and cancer. However, it is rarely reported that the kidney transplant recipient (KTR) had pulmonary tuberculosis and lung cancer simultaneously. Case presentations: A 60-year-old male was admitted because of persistent lung shadow for two years without any obvious symptom eight years after renal transplant. T-SPOT test was positive but other etiological examinations for Mycobacterium tuberculosis were negative. Chest CT scan revealed two pulmonary lesions in the right upper and lower lobe. 18F-fluorodesoxyglucose positron-emission tomography (FDG-PET) CT found FDG intake increased in both pulmonary consolidation lesions. CT-guided percutaneous transthoracic needle biopsy revealed lung adenocarcinoma and tuberculosis. The video-assisted thoracoscopic surgery was operated to resect the malignancy lesions. The patient received specific anti-tuberculosis therapy and was discharged. At the follow-up of 6 months post drug withdrawal, the patient was recovered very well. Conclusion We for the first time reported co-existence of culture-negative pulmonary TB and lung adenocarcinoma in a KTR, which highlighted the clinical awareness of co-occurrence of TB and malignancy after renal transplant and emphasized the value of biopsy and 18F-FDG-PET in early diagnosis of TB and cancer.

Human BK Polyomavirus Nephropathy (BKVN) In Non- Kidney-Transplant Patients

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S118-S118
Author(s):  
Y Chen Wongworawat ◽  
C Zuppan
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Bk Polyomavirus ◽  
Pathologic Features ◽  
Renal Biopsies ◽  
Renal Transplant Patients

Abstract Introduction/Objective Human BK polyomavirus nephropathy (BKVN) occurs in up to 10% of renal transplant recipients, and can result in graft loss. Transplant biopsy is the gold standard to diagnose BKVN, and SV40 immunohistochemical (IHC) staining is helpful in confirming the diagnosis. BKVN is uncommon outside the setting of renal transplantation. To understand more about its occurrence in other contexts, we reviewed our renal biopsies files for cases of BKVN. Methods Our renal biopsy files for the past 20 years were reviewed for all cases with a diagnosis of BKVN or polyoma virus infection, and the clinical characteristics of the affected patients noted. Results Evidence of BKVN was found in 44 renal biopsies, of which 39 (86%) were renal transplant patients. Of the remaining five patients (14%), two had undergone heart transplantation, one lung transplantation, one was undergoing chemotherapy for acute lymphoblastic leukemia, and one patient had active HIV infection. All patients had elevated serum creatinine, and four out of five patients had documented BK viremia. Four of the five biopsies showed typical tubular injury with viral nuclear cytopathic changes (inclusions). In the lung transplant patient, the biopsy showed advanced chronic tubulointerstitial injury without distinct viral inclusions, but SV40 staining confirmed the presence of BK virus antigen. Conclusion The BKVN is distinctly uncommon outside the context of kidney transplantation. In our series, 14% of patients with BKVN were not kidney transplant recipients, but all were immune compromised in some fashion. The pathologic features of BKVN appear similar, regardless of whether the host is a renal transplant recipient or not. Although uncommon, it is important to consider the possibility of BKVN in non-renal transplant patients with persistent or progressive renal dysfunction.

scholarly journals Studying Risk Factors Association with Osteoporosis in Post Kidney Transplantation Patients

2020 ◽  
Vol 11 (1) ◽  
pp. 200-206
Author(s):  
Angham Ahmed Hasan ◽  
Munaf H. Zalzala ◽  
Abbas Al-Temimi
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Female Gender ◽  
Extensive Study ◽  
High Rate ◽  
T Score ◽  
Transplant Patients ◽  
Medical City

Osteoporosis that associate with kidney transplantation is an important cause of ‎morbidity to ‎the patients that warranted extensive study about possible causes of ‎osteoporosis in order to ‎implement several steps to reduce this risk. The current work aimed to investigate possible association between post kidney ‎transplant ‎immunosuppression therapy type and developing the ‎osteoporosis and evaluate the bone mass by using dual X-ray absorptiometry (DXA) post-renalal transplant. A case-control, conducted in kidney transplant center – medical city complex for ‎one year period (‎from October ‎‏2018‏‎ till April 2019), Seventy - five kidney ‎transplant patients were participated in the present study ‎including (21 females & ‎‎54 males). All ‎patients were examined for their bone density using DEXA scan (T – score) and ‎those with cut – point ≤- 2.5 were diagnosed as having osteoporosis (lumber and ‎hip bones were examined). The prevalence of osteoporosis and osteopenia was significantly higher in ‎transplant patients compared to control for bone lumber and hip bone (for ‎lumber bones: 33.3% vs 2.7%l for hip bones: 60% vs. 14.7%). T score was ‎significantly lower in the transplant patients compared to control for both lumber ‎‎(-1.9‎±0.8 vs. -1.1‎±0.7) and hip bones (-2.3‎±0.9 vs -1.3‎±0.8).‎ In logistic regression analysis; only gender and BMI were the predictors of ‎osteoporosis for spinal bone, while; the BMI and calcium were the predictors ‎of osteoporosis for hip bones. In ‏conclusion, Osteoporosis in post-renal transplant patients have a high rate of ‎osteoporosis compared to the general population, post-renal transplant drugs (Cyclosporine, MMF, etc.) did not increase the ‎risk of osteoporosis, and body mass index and female gender were risk factors for osteoporosis

scholarly journals Cytomegalovirus Viremia and Risk Factors in Renal Transplant Recipients in Iran: a Prospective Case-control Study

2021 ◽  
Author(s):  
Najmeh Parhizgari ◽  
Farhad Rezaei ◽  
Mohamad-Reza Khatami ◽  
Sayed Mahdi Marashi ◽  
Mohammad Farahmand ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Control Study ◽  
Prospective Case Control Study

Abstract Background: In spite of effective anti-viral drugs and risk-balanced prophylaxis regimen, cytomegalovirus (CMV) remains a major reason of morbidity in kidney transplant patients. The aim of present study was to evaluate CMV viral load and laboratory findings correlation with CMV viremia graft origin and investigation on late or early onset CMV infection in kidney transplant recipients with CMV viremia. Methods: This research designed as a prospective case-control study based on CMV PCR test and exclusion of other viral infection among renal transplant patients in Iran.Results: From 192 examined patients, 153 participants were qualified to enter the study: 43 in case (with CMV viremia) and 110 in control group (CMV negative test). Statistical analysis performed to identify the risk factors raising this viral viremia among kidney transplant patients. Conclusion: Receiving a renal graft from a deceased donor significantly raise the chance of viremia in renal transplant patients. The median month of CMV viremia occurrence was month 4 after transplantation in both groups. Serum laboratory testing showed creatinine and platelets significantly raised and reduced, retrospectively in the case compare to control group. Our results indicating the viremia has not affected the survival of the allograft or patient.

scholarly journals 2662. Methenamine Hippurate Decreases the Incidence of Urinary Tract Infections in Adult Renal Transplant Recipients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S931-S932
Author(s):  
Orlando Quintero ◽  
Yoram Puius ◽  
Vagish Hemmige
Keyword(s):  
Urinary Tract ◽  
Renal Transplant ◽  
Creatinine Clearance ◽  
Kidney Transplant ◽  
Urinary Tract Infections ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Number Of Patients ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are a common complication of renal transplantation. Methenamine hippurate is a non-antibiotic alternative that reduces the frequency of UTIs in selected non-transplant patients, but which is not recommended in renal insufficiency. We conducted a retrospective study to determine the efficacy of methenamine prophylaxis in our kidney transplant population, and identify subgroups for which efficacy is greatest. Methods Retrospective chart review of adult kidney transplant patients at Montefiore Medical Center who were prescribed methenamine during January 1, 2016–December 31, 2017, with extraction of clinical data in the year before and after prophylaxis. Variables included demographics, creatinine clearance and hemoglobin A1c levels at the time of prescription, incidence of UTIs as determined by standardized literature definitions, hospital admissions for infections, and antibiotic use. Results The incidence of UTIs per 1000 patient-days decreased significantly, from 9.66 (95% CI 7.53–12.40) the year before to 3.24 (95% CI 2.00–5.24) the year after (P < 0.001). The effect was significantly more pronounced in patients who were transplanted due to diabetic nephropathy, with a decreased incidence of 13.05 (95% Cl 10.00–17.02) UTIs/1000 patient-days to 2.90 (95% Cl 1.58–5.32) in diabetics (P < 0.001), vs. 5.50 (95% Cl 3.65–8.28) UTIs/1000 patient-days to 3.81 (95% Cl 1.70–8.55) in non-diabetics (P = 0.44). The number of days of antibiotics for UTIs per 1000 days also decreased significantly for all patients, from 128.58 (95% CI 94.87–174.28) the year before to 49.78 (95% CI 31.74–78.07) the year after (P = 0.001). No significant differences in efficacy were seen based on sex or renal function. Three patients with indwelling urinary catheters or who required intermittent catheterization did not appear to benefit Conclusion Methenamine prophylaxis decreases the incidence of UTIs and number of antibiotic days in adult renal transplant recipients. This effect was seen even in patients with reduced creatinine clearance. Patients with diabetes benefited the most. The small number of patients who required catheterization did not appear to benefit. Disclosures All authors: No reported disclosures.

Diagnostic difficulties caused by a pulmonary infiltrate

2012 ◽  
Vol 153 (27) ◽  
pp. 1077-1081
Author(s):  
Zsófia Simon ◽  
Ádám Jóna ◽  
Zsófia Miltényi ◽  
Edit Páyer ◽  
Attila Lieber ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Stage Iv ◽  
Definitive Treatment ◽  
Atypical Pneumonia ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Pet Ct ◽  
Diagnostic Difficulties ◽  
Fdg Pet Ct

Lung infiltration still causes differential diagnostic difficulties, which may delay the start of definitive treatment. Case report: The examination of a 30-year-old man began due intermittent, remittent and permanent fever. Chest X-ray confirmed infiltration in the right upper lobe, which was accompanied by elevated CRP and physiological levels of procalcitonin. Most likely atypical pneumonia, tuberculosis, Wegener’s granulomatosis or a malignant process was suspected. Throughout his examination infection could not be verified, repeated CT guided transthoracic needle biopsy suggested the possibility of a malignant process. Through surgical exploration the intraoperative histology was not informative; thus, the pneumonitis-remodelled right lung was removed due to the possibility of malignant transformation. Histological examination revealed lymphocyte rich classical Hodgkin lymphoma, which was found to be stage IV/B based on the 18FDG-PET/CT scan; therefore, eight cycles of ABVD (adriablastin, bleomycin, vinblastine, and dacarbazine) therapy was administered successfully. The patient is currently (for 30 months) in a complete metabolic remission. Conclusion: Primary pulmonary Hodgkin lymphoma is a rare disease entity (in this case it might be the original process), in which the diagnosis is often difficult. 18FDG-PET/CT may be a useful early diagnostic tool investigating fever of unknown origin. Orv. Hetil., 2012, 153, 1077–1081.

scholarly journals A Case of Lung Adenocarcinoma Originating from an Old Posttraumatic Scar in a Young Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Fatima Ahmed ◽  
Hassaan Yasin ◽  
Hesham E. Mohamed
Keyword(s):  
Lung Adenocarcinoma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Left Lung ◽  
Lower Lobe ◽  
Left Lower Lobe ◽  
Pulmonary Contusion ◽  
Mediastinal Lymphadenopathy ◽  
Ct Guided ◽  
Ct Guided Biopsy

A relationship between lung scarring and cancer has been recognized for many decades but more evidence is needed to strengthen this association. A 34-year-old nonsmoker male with a history of left lower lobe lung scar secondary to a pulmonary contusion from a motor vehicle accident in 2012 was admitted with shortness of breath and cough. A computed tomography (CT) angiography of the chest demonstrated bilateral pulmonary emboli, left lower lobe mass, left lung septal thickening, and mediastinal lymphadenopathy. A CT-guided biopsy of the mass was performed, and pathology was consistent with lung adenocarcinoma. Staging work-up revealed a widely metastatic disease. The patient developed severe complications requiring hospitalization after the first cycle of chemotherapy and subsequently passed away. Lung scar carcinoma originates around peripheral scars resulting from a variety of infections, injuries, and lung diseases. It has poor prognosis because it metastasizes from relatively small lesions. Our case further endorses that lung scarring can potentially lead to the development of cancer. Furthermore, we want to highlight the need to conduct studies to determine if monitoring this patient population with periodic imaging can have a survival benefit.

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