Yin Liu1, Zheng Wang2, Guang Yao3, Yuying Lu3, Zhongyang Hu3, Huan Yao2, Qinghua Zhang3, Haixia Zhu3, Zhi Song3, Wei Wang1, Ding Liu4. 1. Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Department of Neurology, Changsha Central Hospital, Changsha, Hunan, China. 3. Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 4. Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: bubu1881@gmail.com.
Abstract
OBJECTIVE: The aim of this study was to investigate the occurrence of paradoxical reaction (PR) in HIV-negative tuberculous meningitis (TBM) patients with spinal involvement, as well as its possible risk factors. METHODS: Fifty TBM patients with spinal involvement were studied retrospectively and divided into a PR group and a non-PR group according to the presence of PR. Their demographic, clinical, radiological, and laboratory data, and status at follow-up were collected and compared. RESULTS: PR developed in 26 patients (52%), with the median time to the development of PR being 30days (range 15-330 days) after the initiation of tuberculosis therapy. At initial diagnosis, age, documented acid-fast bacilli (AFB), and the cerebrospinal fluid protein level were found to differ significantly between the two groups. After multivariate analysis, age, documented AFB, and vertebral involvement were significantly associated with the development of PR. CONCLUSIONS: PR was common in TBM patients with spinal involvement. Age, documented AFB, and musculoskeletal involvement may be predictors of PR development.
OBJECTIVE: The aim of this study was to investigate the occurrence of paradoxical reaction (PR) in HIV-negative tuberculous meningitis (TBM) patients with spinal involvement, as well as its possible risk factors. METHODS: Fifty TBM patients with spinal involvement were studied retrospectively and divided into a PR group and a non-PR group according to the presence of PR. Their demographic, clinical, radiological, and laboratory data, and status at follow-up were collected and compared. RESULTS: PR developed in 26 patients (52%), with the median time to the development of PR being 30days (range 15-330 days) after the initiation of tuberculosis therapy. At initial diagnosis, age, documented acid-fast bacilli (AFB), and the cerebrospinal fluid protein level were found to differ significantly between the two groups. After multivariate analysis, age, documented AFB, and vertebral involvement were significantly associated with the development of PR. CONCLUSIONS: PR was common in TBM patients with spinal involvement. Age, documented AFB, and musculoskeletal involvement may be predictors of PR development.
Authors: Cláudia Elizabeth Volpe-Chaves; Mara Luci Gonçalves Galiz Lacerda; Suse Barbosa Castilho; Simone Sousa Oliveira Fonseca; Bruna Abdul Ahad Saad; Caroline Franciscato; Tiago Kojun Tibana; Thiago Franchi Nunes; James Venturini; Sandra Maria do Valle Leone de Oliveira; Anamaria Mello Miranda Paniago Journal: Medicine (Baltimore) Date: 2020-05-22 Impact factor: 1.817