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Article: Risk factors for pulmonary tuberculosis in bone marrow transplant recipients

TitleRisk factors for pulmonary tuberculosis in bone marrow transplant recipients
Authors
Issue Date1998
PublisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.org
Citation
American Journal Of Respiratory And Critical Care Medicine, 1998, v. 158 n. 4, p. 1173-1177 How to Cite?
AbstractLittle is known about the profile of infection with Mycobacterium tuberculosis in bone marrow transplant (BMT) recipients. Of five BMT series with a total of more than 5,000 patients, only 10 cases of M. tuberculosis infection were described, with an overall incidence of 0.19%. We have conducted a prospective evaluation of 183 consecutive BMT recipients, and 10 patients were found to develop pulmonary tuberculosis post-BMT, yielding an incidence of 5.5%. We described the clinical features of these 10 patients, and analyzed the risk factors for development of tuberculosis using age- and sex-matched case control subjects who did not develop the disease. The median age of the 10 patients who developed tuberculosis was 29 yr (range, 17 to 40 yr). The median time for onset of symptoms was 150 d (range, 23 to 550 d), mainly presenting with fever and cough, with infiltrates on chest radiograph. Respiratory tract specimens, mostly sputum, yielded positive smears for acid- fast bacilli in three and positive M. tuberculosis culture in eight, whereas lung tissue histology was the first diagnostic test in two patients. Treatment with standard antituberculosis drugs for a longer duration was highly effective, with no excessive side effects Risk factors identified for development of tuberculosis included allogeneic BMT (p < 0.05, relative risk [RR] 23.7), total body irradiation (p < 0.05, RR 4.9), and chronic graft- versus-host disease (GVHD) (p < 0.05, RR 3.6). It is postulated that chronic GVHD predisposed to development of tuberculosis mainly via disruption of host reconstitution of immune defenses against M. tuberculosis.
Persistent Identifierhttp://hdl.handle.net/10722/49082
ISSN
2015 Impact Factor: 13.118
2015 SCImago Journal Rankings: 5.832
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorIp, MSMen_HK
dc.contributor.authorYuen, KYen_HK
dc.contributor.authorWoo, PCYen_HK
dc.contributor.authorLuk, WKen_HK
dc.contributor.authorTsang, KWTen_HK
dc.contributor.authorLam, WKen_HK
dc.contributor.authorLiang, RHSen_HK
dc.date.accessioned2008-06-12T06:34:01Z-
dc.date.available2008-06-12T06:34:01Z-
dc.date.issued1998en_HK
dc.identifier.citationAmerican Journal Of Respiratory And Critical Care Medicine, 1998, v. 158 n. 4, p. 1173-1177en_HK
dc.identifier.issn1073-449Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/49082-
dc.description.abstractLittle is known about the profile of infection with Mycobacterium tuberculosis in bone marrow transplant (BMT) recipients. Of five BMT series with a total of more than 5,000 patients, only 10 cases of M. tuberculosis infection were described, with an overall incidence of 0.19%. We have conducted a prospective evaluation of 183 consecutive BMT recipients, and 10 patients were found to develop pulmonary tuberculosis post-BMT, yielding an incidence of 5.5%. We described the clinical features of these 10 patients, and analyzed the risk factors for development of tuberculosis using age- and sex-matched case control subjects who did not develop the disease. The median age of the 10 patients who developed tuberculosis was 29 yr (range, 17 to 40 yr). The median time for onset of symptoms was 150 d (range, 23 to 550 d), mainly presenting with fever and cough, with infiltrates on chest radiograph. Respiratory tract specimens, mostly sputum, yielded positive smears for acid- fast bacilli in three and positive M. tuberculosis culture in eight, whereas lung tissue histology was the first diagnostic test in two patients. Treatment with standard antituberculosis drugs for a longer duration was highly effective, with no excessive side effects Risk factors identified for development of tuberculosis included allogeneic BMT (p < 0.05, relative risk [RR] 23.7), total body irradiation (p < 0.05, RR 4.9), and chronic graft- versus-host disease (GVHD) (p < 0.05, RR 3.6). It is postulated that chronic GVHD predisposed to development of tuberculosis mainly via disruption of host reconstitution of immune defenses against M. tuberculosis.en_HK
dc.format.extent418 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.orgen_HK
dc.relation.ispartofAmerican Journal of Respiratory and Critical Care Medicineen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshBone Marrow Transplantation - adverse effects - immunologyen_HK
dc.subject.meshTuberculosis, Pulmonary - drug therapy - etiology - immunology - physiopathology -en_HK
dc.subject.meshAntitubercular Agents - therapeutic useen_HK
dc.subject.meshGraft vs Host Disease - complications - immunologyen_HK
dc.subject.meshLung - microbiology - pathology - radiographyen_HK
dc.titleRisk factors for pulmonary tuberculosis in bone marrow transplant recipientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1073-449X&volume=158&issue=4&spage=1173&epage=1177&date=1998&atitle=Risk+factors+for+pulmonary+tuberculosis+in+bone+marrow+transplant+recipientsen_HK
dc.identifier.emailIp, MSM:msmip@hku.hken_HK
dc.identifier.emailYuen, KY:kyyuen@hkucc.hku.hken_HK
dc.identifier.emailWoo, PCY:pcywoo@hkucc.hku.hken_HK
dc.identifier.emailLiang, RHS:rliang@hku.hken_HK
dc.identifier.authorityIp, MSM=rp00347en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.identifier.authorityWoo, PCY=rp00430en_HK
dc.identifier.authorityLiang, RHS=rp00345en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid9769278-
dc.identifier.scopuseid_2-s2.0-0031767067en_HK
dc.identifier.hkuros37705-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031767067&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume158en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1173en_HK
dc.identifier.epage1177en_HK
dc.identifier.isiWOS:000076453300026-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridIp, MSM=7102423259en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.scopusauthoridWoo, PCY=7201801340en_HK
dc.identifier.scopusauthoridLuk, WK=7005237832en_HK
dc.identifier.scopusauthoridTsang, KWT=7201555024en_HK
dc.identifier.scopusauthoridLam, WK=7203021937en_HK
dc.identifier.scopusauthoridLiang, RHS=26643224900en_HK

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