PERITONEAL TUBERCULOSIS AND CONTINUOUS AM BULATORY PERITONEAL-DIALYSIS

Depressed immunity in uremic patients increases by ten the risk of tub erculosis. In such patients, 40% of tuberculosis manifestations are ex trapulmonary, and peritoneum is involved in about 6% of the cases. Sev enteen cases of peritoneal tuberculosis have been so far reported in C APD patients, and we add a new case. The prognosis of the disease is s evere since 8 patients died. Three deaths out of 8 are directly linked to tuberculosis. Indeed, peritoneal tuberculosis diagnosis is hard an d often late, at least for two main reasons: at first, it can be diffi cult to exclude the other causes of lymphocytic peritonitis (viral, fu ngal, bacterial, etc..), secondly, growth of mycobacteria in dialysate effluent cultures is late and inconstant. Omental biopsy in lymphocyt ic peritonitis of unknown origin could be of great value for an early diagnosis. Despite the adaptation of antituberculous drugs doses, side -effects are not so rare: optical neuritis and liver toxicity in our c ase. In spite of ultrafiltration loss, stopping CAPD is not always nec essary, as in the reported case.