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2018 ; 44
(2
): 161-166
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Chest X-ray and chest CT findings in patients diagnosed with pulmonary
tuberculosis following solid organ transplantation: a systematic review
#MMPMID29791554
Giacomelli IL
; Schuhmacher Neto R
; Marchiori E
; Pereira M
; Hochhegger B
J Bras Pneumol
2018[Apr]; 44
(2
): 161-166
PMID29791554
show ga
The objective of this systematic review was to select articles including chest
X-ray or chest CT findings in patients who developed pulmonary tuberculosis
following solid organ transplantation (lung, kidney, or liver). The following
search terms were used: "tuberculosis"; "transplants"; "transplantation";
"mycobacterium"; and "lung". The databases used in this review were PubMed and
the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected
articles in English, Portuguese, or Spanish, regardless of the year of
publication, that met the selection criteria in their title, abstract, or body of
text. Articles with no data on chest CT or chest X-ray findings were excluded, as
were those not related to solid organ transplantation or pulmonary tuberculosis.
We selected 29 articles involving a collective total of 219 patients. The largest
samples were in studies conducted in Brazil and South Korea (78 and 35 patients,
respectively). The imaging findings were subdivided into five common patterns.
The imaging findings varied depending on the transplanted organ in these
patients. In liver and lung transplant recipients, the most common pattern was
the classic one for pulmonary tuberculosis (cavitation and "tree-in-bud"
nodules), which is similar to the findings for pulmonary tuberculosis in the
general population. The proportion of cases showing a miliary pattern and lymph
node enlargement, which is most similar to the pattern seen in patients
coinfected with tuberculosis and HIV, was highest among the kidney transplant
recipients. Further studies evaluating clinical data, such as immunosuppression
regimens, are needed in order to improve understanding of the distribution of
these imaging patterns in this population.