Vitamin_D - Consensus? Treat active TB after renal...

Info iconThis preview shows pages 1–11. Sign up to view the full content.

View Full Document Right Arrow Icon
Consensus? Treat active TB after renal transplantation with the same therapy as general population (Evidence level B) If rifampin is used, monitor blood levels of calcineurin inhibitors and rapamycin. Use rifabutin as an alternative (Evidence level C)
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Risk factors for Post-TxTB DM Chronic liver disease Cyclosporine therapy
Background image of page 2
Case series Mycobacterial infection in 1261 renal transplant pts 27pts (2.1%) developed infection (20 had M. Tb) Mean age 40 years old with mean time of immunosuppression=26 months Immunosuppression was continued in all cases and doses were adjusted according to levels
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
TB dissemination rates – 1% in general population vs 35% in post Tx pts. No difference with cyclosporine vs “conventional therapy”. However, risk is higher with the use of OKT3 (anti-CD3 monoclonal antibody) From another study, TAC or MMF were associated with development of TB earlier and in younger patients
Background image of page 4
Vitamin D: A New Old Cure for TB? Alexander Usorov, MD 9-18-07
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Overview Is TB that big of a deal? What do the observational studies show? What are the mechanisms of action?
Background image of page 6
TB – a big deal? Global emergency M. Tb. Kiils a human being every 15 seconds 8.8 million new cases in 2003 1.7 million deaths 1/3 of World’s population is infected with M. tubecrulosis
Background image of page 7

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Leading cause of death in women of reproductive age and HIV pts In the US, 10-15 milllion ppl are infected Leading cause of death in AIDS pts Higher prevalence of XDR TB in AIDS pts
Background image of page 8
Observations 1903 – Niels Ryberg Finsen wins Nobel prize for demonstrating that UV light treats pts with lupus vulgaris (cutaneous form of TB) 1905 – Robert Koch wins Nobel prize for isolating tubercle bacilli (which he did in 1882)
Background image of page 9

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
1854 – Hermann Brehmer opens first ever sanatorium (himself suffered from TB) 1887 – Edward Livingston Trudeau opens first sanatorium in the United States (Saranac Lake, NY) after observing that rabbits infected with TB had a more severe course if kept indoors in the dark.
Background image of page 10
Image of page 11
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

Page1 / 21

Vitamin_D - Consensus? Treat active TB after renal...

This preview shows document pages 1 - 11. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online