Renal manifestations in children co-infected with HIV and disseminated tuberculosis

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dc.contributor.authorNourse P.J.
dc.contributor.authorCotton M.F.
dc.contributor.authorBates W.D.
dc.date.accessioned2011-05-15T16:17:39Z
dc.date.available2011-05-15T16:17:39Z
dc.date.issued2010
dc.description.abstractMany children in Cape Town are co-infected with human immunodeficiency virus (HIV) and tuberculosis (TB). Granulomatous TB interstitial nephritis is a recognized entity. Our objective was to establish if TB plays a role in renal disease in HIV-infected children. We identified children co-infected with TB and HIV from our database and reviewed their biopsies and clinical notes. Since 2002, 12 renal biopsies or postmortem examinations were performed on HIV-infected children at our institution. The clinical scenario and renal biopsies in four cases (median age 73 months, range 24-108 months) were consistent with TB involvement. The mean CD4 count and percentage of these four patients were 508 cells/μl and 23%, respectively. All four patients presented with culture-proven disseminated TB (not yet on treatment) and had nephrotic range proteinuria and hypoalbuminemia. Three of these patients had renal impairment. The prominent features of the renal biopsies were a severe interstitial inflammatory infiltrate and mild to moderate mesangial proliferation. An interstitial granuloma was seen in one patient. With treatment for the TB, the proteinuria resolved and renal function improved in all four patients. Based on these results, we conclude that TB contributes to proteinuric renal disease in HIV-infected children and that the renal disease improves following TB treatment. © 2010 IPNA.
dc.description.versionArticle
dc.identifier.citationPediatric Nephrology
dc.identifier.citation25
dc.identifier.citation9
dc.identifier.issn0931041X
dc.identifier.other10.1007/s00467-010-1520-3
dc.identifier.urihttp://hdl.handle.net/10019.1/14312
dc.subjectantiretrovirus agent
dc.subjecttuberculostatic agent
dc.subjectarticle
dc.subjectautopsy
dc.subjectcase report
dc.subjectCD4 lymphocyte count
dc.subjectchild
dc.subjectdisease severity
dc.subjectfemale
dc.subjecthighly active antiretroviral therapy
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjecthuman tissue
dc.subjecthypoalbuminemia
dc.subjectinterstitial nephritis
dc.subjectkidney biopsy
dc.subjectkidney hypertrophy
dc.subjectmale
dc.subjectmiliary tuberculosis
dc.subjectmixed infection
dc.subjectpriority journal
dc.subjectproteinuria
dc.subjectAntitubercular Agents
dc.subjectBiopsy
dc.subjectCell Proliferation
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectFemale
dc.subjectGlomerular Mesangium
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectHypoalbuminemia
dc.subjectKidney
dc.subjectKidney Diseases
dc.subjectMale
dc.subjectNephritis, Interstitial
dc.subjectNephrotic Syndrome
dc.subjectProteinuria
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.subjectTuberculosis
dc.subjectTuberculosis, Renal
dc.titleRenal manifestations in children co-infected with HIV and disseminated tuberculosis
dc.typeArticle
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