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Tuberculous spondylitis is more common in patients with chronic renal failure who receive hemodialysis because of their abnormal T-cell-mediated immunity. It frequently poses both diagnostic and therapeutic challenges. We describe two cases of tuberculous spondylitis in patients undergoing chronic hemodialysis therapy. They are IFN-γ assay diagnosed (QuantiFERON-TB Gold) and conservatively treated. Our cases suggest that IFN-γ assays equip clinicians with more accurate tools for tuberculosis control. A combination of T-SPOT.TB testing and MRI assessment may be the accurate method to diagnose tuberculous spondylitis in patients with end-stage renal disease.
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