Tuberculous hepatitis in renal transplant recipients following alemtuzumab induction therapy

Transpl Infect Dis. 2013 Feb;15(1):E33-9. doi: 10.1111/tid.12048. Epub 2012 Dec 26.

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.

Publication types

  • Case Reports

MeSH terms

  • Alemtuzumab
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antitubercular Agents / therapeutic use*
  • Female
  • Graft Rejection / prevention & control
  • Humans
  • Immunocompromised Host
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation*
  • Middle Aged
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / etiology*
  • Treatment Outcome
  • Tuberculosis, Hepatic / drug therapy
  • Tuberculosis, Hepatic / etiology*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antitubercular Agents
  • Immunosuppressive Agents
  • Alemtuzumab