A case report of ocular tuberculosis in a patient with membranous nephropathy

Medicine (Baltimore). 2019 Jan;98(1):e13892. doi: 10.1097/MD.0000000000013892.

Abstract

Rationale: Membranous nephropathy (MN), a chronic kidney disease (CKD), due to hypoproteinemia, malnutrition, anemia, long-term intake of immunosuppressive agents, changes in cellular immune state, and decrease in antimicrobial peptides, is a high risk for Mycobacterium tuberculosis (MTB) infection, which can cause tuberculosis (TB). TB manifests by various clinical symptoms. Ocular symptoms is a rare presentation of TB. Here, we describe a case of ocular tuberculosis in a patient with MN.

Patient concerns: A 63-year-old man with membranous nephropathy (MN) history presented with ocular symptoms.

Diagnoses: According to the pathological manifestations of ocular tissue biopsy and a positive polymerase chain reaction (PCR) on samples from sputum and bronchoalveolar lavage fluid (BALF), we elicited a diagnosis of disseminated tuberculosis.

Intervention: The patient received antituberculous therapy and immunosuppressive therapy.

Outcomes: The clinical manifestations significantly improved.

Lessons: Clinicians should be aware of the possibility of TB in cases of immunocompromised patients and perform an appropriate diagnostic work-up for TB.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid / microbiology
  • Glomerulonephritis, Membranous / complications*
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Sputum / microbiology
  • Tuberculosis, Ocular / complications*
  • Tuberculosis, Ocular / drug therapy

Substances

  • Antitubercular Agents