关键词:

肾移植 , 肺结核 , 临床特点 , 早期诊断

Abstract:

Objective To analyze the clinical characteristics and early diagnosis methods of pulmonarytuberculosis infection after renal transplantation in order to offer assistances for the early diagnosis of pulmonary tuberculosis. Methods A retrospective study was performed on 6 cases of patients with pulmonary tuberculosiswho were admitted from 2005 to 2020. Results The incidence of pulmonary tuberculosis after kidney transplantation in our hospital was 0.6%. Most of the patients had fever as the first or only manifestation，mainly low fever. Only 2 cases of them had respiratory symptoms. Of all the patients，only 2 cases had typical pulmonarytuberculosis imaging changes，and the other 4 cases had no specific imaging performances. Only one of 6 patients was positive for acid fast staining from sputum smear，and mycobacterium tuberculosis was found in peripheral blood samples by mNGS. And only 1 patient was PPD positive，four patients were T-SPOT positive，and one patient was finally confirmed by lung biopsy. Conclusion Pulmonary tuberculosis infection after renal transplantation was increasing in recent years. Due to the influences of immunosuppressive agents，most patients with pulmonary tuberculosis after renal transplantation have atypical clinical symptoms or signs，these patients may lack of respiratory symptoms and specificity in imaging results，they may have high false negative rate of traditional PPD test and low detection rate of mycobacterium tuberculosis. These features lead to difficulties in early diagnosis. IGRA test and mNGS are relatively new detection methods with high sensitivity and specificity，which are conducive to the early diagnosis of tuberculosis. And regular，repeated，multiple joint comprehensive detection is conducive to the early diagnosis of tuberculosis.

Key words:

Renal transplantation, Pulmonary tuberculosis, Clinical characteristics, Early diagnosis ,