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A boy undergoing maintenance hemodialysis who developed mediastinal lymph node tuberculosis

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Abstract

The incidence of tuberculosis (TBC) in patients undergoing maintenance hemodialysis is reported to be higher than that in the general population. We report an 8-year-old boy receiving such treatment for chronic renal failure who developed mediastinal lymph node TBC. He showed only intermittent fever, recurring every 2 weeks, with no other symptoms suggesting TBC. Although staining and culture of pharyngeal swab and gastric juice specimens failed to provide evidence of TBC, a lymph node biopsy specimen disclosed typical pathologic findings of tuberculoma, including caseating granulomas. Antituberculous therapy with isoniazid (INH), rifampicin, pyrazinamide, and ethambutol was given for 12 months, resulting in complete resolution of the TBC, with no subsequent recurrence. To our knowledge, mediastinal lymph node localization of TBC is relatively rare, in a patient on maintenance hemodialysis, especially in a child.

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References

  1. F Yamagishi K Shimokata (2003) ArticleTitleTuberculosis in compromised hosts Kekkaku 78 717–22

    Google Scholar 

  2. R Freeman CE Newhouse RL Lawton (1975) ArticleTitleAbsence of tuberculosis in dialysis patients JAMA 233 1356 Occurrence Handle1174202 Occurrence Handle1:STN:280:DyaE28%2Fgsl2gsQ%3D%3D Occurrence Handle10.1001/jama.233.13.1356c

    Article  PubMed  CAS  Google Scholar 

  3. KT Hsu KK Lam SC Liao CC Liu JB Che (1996) ArticleTitlePrevalence of pulmonary tuberculosis in end-stage renal disease (ESRD) patients is not unusually high Clin Nephrol 45 279–80 Occurrence Handle8861807 Occurrence Handle1:STN:280:DyaK2s%2FhsV2ktg%3D%3D

    PubMed  CAS  Google Scholar 

  4. A Mitwalli (1991) ArticleTitleTuberculosis in patients on maintenance dialysis Am J Kidney Dis 18 579–82 Occurrence Handle1951338 Occurrence Handle1:STN:280:DyaK38%2FlvFShsg%3D%3D

    PubMed  CAS  Google Scholar 

  5. H Taskapan C Utas FS Oymak I Gulmez M Ozesmin (2000) ArticleTitleThe outcome of tuberculosis in patients on chronic hemodialysis Clin Nephrol 54 134–7 Occurrence Handle10968689 Occurrence Handle1:STN:280:DC%2BD3M%2Fmslaksg%3D%3D

    PubMed  CAS  Google Scholar 

  6. J Moran M Blumenstein HJ Gurland (1990) ArticleTitleImmunodeficiencies in chronic renal failure Contrib Nephrol 86 91–106 Occurrence Handle2078954 Occurrence Handle1:STN:280:DyaK3M7ns1OlsA%3D%3D

    PubMed  CAS  Google Scholar 

  7. MC Belcon EK Smith LM Kahana AG Shimizu (1982) ArticleTitleTuberculosis in dialysis patients Clin Nephrol 17 14–8 Occurrence Handle7055993 Occurrence Handle1:STN:280:DyaL387hsF2htQ%3D%3D

    PubMed  CAS  Google Scholar 

  8. SA Shohaib EM Scrimgeour F Shaerya (1999) ArticleTitleTuberculosis in active dialysis patients in Jeddah J Nephrol 19 34–7 Occurrence Handle1:STN:280:DyaK1M7os12qtg%3D%3D Occurrence Handle10.1159/000013422

    Article  CAS  Google Scholar 

  9. E Ferrara J Lemire PC Grimm VM Reznik SA Mendoza JA Leake et al. (2004) ArticleTitleMycobacterial peritonitis in pediatric peritoneal dialysis patients Pediatr Nephrol 19 114–7 Occurrence Handle14648331 Occurrence Handle10.1007/s00467-003-1348-1

    Article  PubMed  Google Scholar 

  10. KJ Chou HC Fang KJ Bai SJ Hwang WC Yang HM Chung (2001) ArticleTitleTuberculosis in maintenance dialysis patients Nephron 88 138–43 Occurrence Handle11399916 Occurrence Handle1:STN:280:DC%2BD3Mzjt1WltA%3D%3D Occurrence Handle10.1159/000045974

    Article  PubMed  CAS  Google Scholar 

  11. SL Lui S Tang FK Li BY Choy TM Chan WK Lo et al. (2001) ArticleTitleTuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis Am J Kidney Dis 38 1055–60 Occurrence Handle11684559 Occurrence Handle1:STN:280:DC%2BD3MngvFOjtw%3D%3D

    PubMed  CAS  Google Scholar 

  12. RH Surekha LV Vijaya G Sumanlatha KJ Murthy (2005) ArticleTitleCell-mediated immune responses in children towards secreted proteins of Mycobacterium bovis BCG Tuberculosis (Edinb) 85 89–93 Occurrence Handle10.1016/j.tube.2004.09.010 Occurrence Handle1:CAS:528:DC%2BD2MXjtVGqsr4%3D

    Article  CAS  Google Scholar 

  13. TH Ottenhoff FA Verreck MA Hoeve E van de Vosse (2005) ArticleTitleControl of human host immunity to mycobacteria Tuberculosis (Edinb) 85 53–64 Occurrence Handle1:CAS:528:DC%2BD2MXjtVGru7c%3D Occurrence Handle10.1016/j.tube.2004.09.011

    Article  CAS  Google Scholar 

  14. WM Newberry JP Sanford (1971) ArticleTitleDefective cellular immunity in renal failure: depression of reactivity of lymphocytes to phytohemagglutinin by renal failure serum J Clin Invest 50 1262–71 Occurrence Handle5578233 Occurrence Handle1:CAS:528:DyaE3MXktFOqsLY%3D Occurrence Handle10.1172/JCI106604

    Article  PubMed  CAS  Google Scholar 

  15. KF Woeltje A Mathew M Rothstein S Seiler VJ Fraser (1998) ArticleTitleTuberculosis infection and anergy in hemodialysis patients Am J Kidney Dis 31 848–52 Occurrence Handle9590196 Occurrence Handle1:STN:280:DyaK1c3ltVSkug%3D%3D

    PubMed  CAS  Google Scholar 

  16. NE Tolkoff-Rubin RH Rubin (1990) ArticleTitleUremia and host defenses N Engl J Med 322 770–2 Occurrence Handle2308604 Occurrence Handle1:STN:280:DyaK3c7nsVahsQ%3D%3D Occurrence Handle10.1056/NEJM199003153221109

    Article  PubMed  CAS  Google Scholar 

  17. H Huber D Pastner P Dittrich H Braunsteiner (1969) ArticleTitleIn vitro reactivity of human lymphocytes in uremia. A comparison with the impairment of delayed hypersensitivity Clin Exp Immunol 5 75–82 Occurrence Handle5789563 Occurrence Handle1:STN:280:DyaF1M3hvVGjtw%3D%3D

    PubMed  CAS  Google Scholar 

  18. SI Vas (1994) ArticleTitleRenaissance of tuberculosis in the 1990s: lessons for the nephrologist Perit Dial Int 14 209–14 Occurrence Handle7948229 Occurrence Handle1:STN:280:DyaK2M%2FjsFeitg%3D%3D

    PubMed  CAS  Google Scholar 

  19. K Cengiz (1996) ArticleTitleIncreased incidence of tuberculosis in patients undergoing hemodialysis Nephron 73 421–4 Occurrence Handle8832601 Occurrence Handle1:STN:280:DyaK28vivFGjsg%3D%3D Occurrence Handle10.1159/000189104

    Article  PubMed  CAS  Google Scholar 

  20. M Al-Homrany (1997) ArticleTitleSuccessful therapy of tuberculosis in hemodialysis patients Am J Nephrol 17 32–5 Occurrence Handle9057950 Occurrence Handle1:STN:280:DyaK2s3htV2hsw%3D%3D Occurrence Handle10.1159/000169068

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Tsukasa Takemura.

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Okada, M., Sugimoto, K., Yagi, K. et al. A boy undergoing maintenance hemodialysis who developed mediastinal lymph node tuberculosis. Clin Exp Nephrol 10, 152–155 (2006). https://doi.org/10.1007/s10157-006-0419-6

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  • DOI: https://doi.org/10.1007/s10157-006-0419-6

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