Basille Christopher C Lazaro¹* and Jade D Jamias²

¹Division of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Diliman, Quezon City, Metro Manila, Philippines

*Corresponding Author: Basille Christopher C Lazaro, Division of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Diliman, Quezon City, Metro Manila, Philippines.

Received: April 06, 2023; Published: May 05, 2023

Abstract

Tuberculosis of the Jejunum is a rare disease in a solid organ transplant patient. It can present a wide range of symptoms, including fever, vague abdominal pain, weight loss, or blood in the stool, making it difficult to differentiate from another disease process. A high index of clinical suspicion is necessary, and a systematic approach involving endoscopic techniques, imaging studies, and diagnostic laparoscopy as the final approach for histopathologic diagnosis.

This is a case of a 44-year-old male, known End-Stage Renal Disease, post kidney transplant with graft loss and history of pulmonary tuberculosis (PTB) treatment in 2016, who presented with a two-year history of intermittent abdominal pain associated with episodes of low-grade fever, body pains, night sweats, and melena. A stepwise approach for diagnosis was done which included upper and lower endoscopy, CT scan of the abdomen, capsule endoscopy, and lastly with diagnostic laparoscopy, which finally revealed a diagnosis of tuberculosis of the jejunum. The patient was started on quadruple anti-Koch's treatment with significant improvement in his symptoms and was discharged improved and stable.

 Keywords: Tuberculosis of the Jejunum; Kidney Transplant Recipient

References

1. Morris., et al. “Mycobacterium tuberculosis infections in solid organ transplantation. AST Infectious Diseases Community of Practice”. American Transplantation (2013).
2. Hosseinzadeh., et al. “Gastrointestinal tuberculosis in a renal transplant recipient presenting with intestinal perforation”. Zahedan Journal of Research in Medical Sciences (ZJRMS) 14.8 (2012): 92-94.
3. Patel., et al. “Clinical and Laboratory Features of Intestinal Tuberculosis”. Clinical and Experimental Gastroenterology (2018).
4. Chong., et al. “Gastrointestinal Tuberculosis”. Singapore Medical Journal 50.6 (2009): 638.
5. Azevedo., et al. “Case Series of Gastrointestinal Tuberculosis in Renal Transplant Patients”. Hindawi Publishing Corporation. Case Reports in Nephrology (2013): 5.
6. Jiang J., et al. “Intestinal Tuberculosis Presenting as an Ileocecal Mass in a Renal Transplant Patient”. Cureus1 (2021): e12995.
7. Stelzmueller., et al. “Abdominal tuberculosis: experience with three cases from an Austrian centre”. European Surgery 41 (2009): 76.
8. Siu., et al. “An unusual case of both upper and lower gastrointestinal bleeding in a kidney transplant recipient”. Transplant Infectious Disease 10 (2008): 276.
9. Jarret., et al. “Gastrointestinal tuberculosis in renal transplant recipients: case report and review of the literature”. Transplant Infectious Disease (2011).
10. Miro., et al. “Pulmonary acremonium abscesses and gastrointestinal tuberculosis manifested as massive upper gastrointestinal bleeding”. Nephrology Dialysis Transplantation 10 (1995): 1444.
11. Ahsan., et al. “Gastrointestinal tuberculosis in renal transplantation: a case report and review”. Clinical Transplant 9 (1995): 349.
12. Singh N and Paterson DL. “Mycobacterium tuberculosis infection in solid organ transplant recipients: impact and implications for management”. Clinical Infectious Diseases5 (1998): 1266-1277.
13. Sikalias N., et al. “Acute abdomen in a transplant patient with tuberculous colitis: a case report”. Cases Journal 2 (2009).
14. Niewczas M., et al. “Tuberculosi in patients after renal transplantation remains still a clinical problem”. Transplantation Proceedings2 (2002): 677-679.

Citation

Citation: Basille Christopher C Lazaro and Jade D Jamias. “Tuberculosis of the Jejunum in a Kidney Transplant Recipient - A Rare Disease: A Case Report". Acta Scientific Gastrointestinal Disorders 6.6 (2023): 08-12.

Copyright

Copyright: © 2023 Basille Christopher C Lazaro and Jade D Jamias. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.