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Articles by A Katsuma
Total Records ( 2 ) for A Katsuma
  D Katagiri , S Masumoto , A Katsuma , E Minami , T Hoshino , T Inoue , M Shibata , M Tada , M Morooka , K Kubota and F. Hinoshita
 

Three patients are reported: two with acute renal failure (ARF) and acute interstitial nephritis (AIN); and one with ARF and rapidly progressive glomerulonephritis (RPGN). In the latter two cases, a percutaneous renal biopsy was performed. In both AIN cases, 2-[18F] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography combined with computed tomography (PET-CT) showed high and diffuse FDG uptake in the renal parenchyma without excretion. Based on the diagnosis of AIN, probable offending drugs were discontinued. Consequently, ARF and AIN recovered gradually in both cases, though haemodialysis (HD) was performed several times. On the other hand, the patient who presented with ARF and RPGN did not accumulate FDG absolutely. Maintenance HD had to be initiated in this patient. FDG-PET-CT might become an auxiliary examination for the diagnosis and follow-up of AIN in oliguric or HD patients.

  T Inoue , T Nakamura , A Katsuma , S Masumoto , E Minami , D Katagiri , T Hoshino , M Shibata , M Tada and F. Hinoshita
 

Background. It is difficult to diagnose tuberculosis (TB) in dialysis patients because of the high rate of extrapulmonary TB in these patients compared with the general population. Recently, a new diagnostic test called QuantiFERON (QFT) has been developed and shown promise as a diagnostic tool for active TB diseases and latent TB infection.

Methods. We examined 162 dialysis patients admitted to a single institute, including 8 patients with active TB, and evaluated the utility of this test in dialysis patients.

Results. Among 162 dialysis patients, positive QFT results occurred in 28 (17.3%), negative QFT results occurred in 95 (58.6%) and indeterminate QFT results occurred in 39 (24.1%). All eight active TB patients had positive QFT results, and none of the 95 patients with negative results had active TB. Among 23 patients with a history of active TB, 10 (43.5%) had positive results. Although the indeterminate rate was relatively high, no patient with an indeterminate result had active TB. Factors such as shorter duration of dialysis, lower lymphocyte count and higher white blood cell count were associated with indeterminate results. Among 105 cases after excluding the patients with previous TB or indeterminate results, the sensitivity of the QFT is 100% (8 of 8) and the specificity is 89.7% (87 of 97 cases).

Conclusions. Our data suggest that the QFT test is a useful supplementary tool for the diagnosis of active TB even in dialysis patients. Negative and indeterminate results on this test may be used to exclude the presence of active TB.

 
 
 
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