Paralytic Ileus during Treatment of Pulmonary and Renal Tuberculosis in a Non-Human Immunodeficiency Virus Patient: An Unusual Presentation of Tuberculosis-immune Reconstitution Inflammatory Syndrome

  • Hashiba Toyohiro
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Sugahara Mai
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Ota Yui
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Kaseda Ken
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Kashiwagi Yusuke
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Nakamura Motonobu
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan
  • Shinohara Takayuki
    Department of Infectious Diseases, the University of Tokyo Hospital, Japan
  • Ikeda Mahoko
    Department of Infectious Diseases, the University of Tokyo Hospital, Japan
  • Okugawa Shu
    Department of Infectious Diseases, the University of Tokyo Hospital, Japan
  • Sugimoto Kazuma
    Department of Urology, the University of Tokyo Hospital, Japan
  • Sasaki Kenichi
    Department of Urology, the University of Tokyo Hospital, Japan
  • Hamasaki Yoshifumi
    Department of Hemodialysis & Apheresis, the University of Tokyo Hospital, Japan
  • Yamada Daisuke
    Department of Urology, the University of Tokyo Hospital, Japan Department of Hemodialysis & Apheresis, the University of Tokyo Hospital, Japan
  • Kume Haruki
    Department of Urology, the University of Tokyo Hospital, Japan
  • Moriya Kyoji
    Department of Infectious Diseases, the University of Tokyo Hospital, Japan
  • Nangaku Masaomi
    Division of Nephrology and Endocrinology, the University of Tokyo Hospital, Japan Department of Hemodialysis & Apheresis, the University of Tokyo Hospital, Japan

抄録

<p>Paralytic ileus as tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) is extremely rare. We herein report a 44-year-old man with pulmonary and renal tuberculosis who developed paralytic ileus 14 days after starting antituberculosis therapy (ATT) despite an initial favorable response to ATT. Paralytic ileus was successfully managed with conservative care. He initially required hemodialysis because of obstructive uropathy due to renal tuberculosis, but he was able to withdraw from dialysis after placement of ureteral stents. TB-IRIS can affect organs other than the original sites of tuberculosis, and the combined use of steroids may be effective for its prevention and treatment. </p>

収録刊行物

  • Internal Medicine

    Internal Medicine 62 (17), 2559-2564, 2023-09-01

    一般社団法人 日本内科学会

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