PMID- 27544714
OWN - NLM
STAT- MEDLINE
DCOM- 20170130
LR  - 20181202
IS  - 1878-3511 (Electronic)
IS  - 1201-9712 (Linking)
VI  - 51
DP  - 2016 Oct
TI  - Paradoxical reaction in immunocompetent children with tuberculosis.
PG  - 15-18
LID - S1201-9712(16)31136-5 [pii]
LID - 10.1016/j.ijid.2016.08.009 [doi]
AB  - BACKGROUND: A paradoxical reaction (PR) during anti-tuberculosis treatment is a 
      phenomenon that is poorly studied in immunocompetent children. It is defined as a 
      clinical or radiological worsening of pre-existing tuberculosis (TB) disease. 
      METHODS: A retrospective descriptive study of children younger than 14 years of 
      age was performed; these children developed PR during the years 2009 to 2014, 
      following a diagnosis of TB. Demographic characteristics, microbiological 
      results, treatment and outcome data were collected. RESULTS: Of 51 children 
      diagnosed with TB, five (9.8%) developed a PR; four of these children had 
      pulmonary TB and the remaining patient had miliary TB with central nervous system 
      involvement. The PR occurred at a median of 42 days (range 23-53 days) after 
      initiating therapy. Corticosteroids were started when PR was suspected, at a 
      median dose of 1mg/kg/day. Clinical and radiological improvement was noted in all 
      cases, with a median clinical regression time of 10.5 days (range 3-15 days) and 
      a median radiological regression time of 45 days (range 26-105 days). No sequelae 
      were described in any patient. CONCLUSIONS: PR in immunocompetent children during 
      anti-tuberculosis treatment is not such an unusual reaction. Treatment with 
      corticosteroids may be useful for the resolution of PR.
CI  - Copyright (c) 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Carazo Gallego, Begona
AU  - Carazo Gallego B
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain. Electronic address: bcarazo002@gmail.com.
FAU - Moreno-Perez, David
AU  - Moreno-Perez D
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
FAU - Nunez Cuadros, Esmeralda
AU  - Nunez Cuadros E
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
FAU - Mesa Fernandez, Alba
AU  - Mesa Fernandez A
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
FAU - Martin Cantero, Maria
AU  - Martin Cantero M
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
FAU - Obando Pacheco, Pablo
AU  - Obando Pacheco P
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
FAU - Urda Cardona, Antonio
AU  - Urda Cardona A
AD  - Infectious Diseases and Immunodeficiencies Unit, Department of Paediatrics, 
      Malaga Regional University Hospital, Avenida Arroyo de los Angeles, s/n, Malaga, 
      29011, Spain.
LA  - eng
PT  - Journal Article
DEP - 20160817
PL  - Canada
TA  - Int J Infect Dis
JT  - International journal of infectious diseases : IJID : official publication of the 
      International Society for Infectious Diseases
JID - 9610933
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Antitubercular Agents/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Tuberculosis/*drug therapy/physiopathology
MH  - Tuberculosis, Miliary/drug therapy
MH  - Tuberculosis, Pulmonary/microbiology
OTO - NOTNLM
OT  - Children
OT  - Corticosteroids
OT  - Immunocompetent
OT  - Paradoxical reaction
OT  - Tuberculosis
EDAT- 2016/10/26 06:00
MHDA- 2017/01/31 06:00
CRDT- 2016/08/22 06:00
PHST- 2016/03/31 00:00 [received]
PHST- 2016/08/09 00:00 [revised]
PHST- 2016/08/11 00:00 [accepted]
PHST- 2016/10/26 06:00 [pubmed]
PHST- 2017/01/31 06:00 [medline]
PHST- 2016/08/22 06:00 [entrez]
AID - S1201-9712(16)31136-5 [pii]
AID - 10.1016/j.ijid.2016.08.009 [doi]
PST - ppublish
SO  - Int J Infect Dis. 2016 Oct;51:15-18. doi: 10.1016/j.ijid.2016.08.009. Epub 2016 
      Aug 17.