Paradoxical response in HIV-negative patients with pleural tuberculosis: a retrospective multicentre study

Authors
K. JeonW-I. ChoiJ. S. AnS. Y. LimW. J. KimG. M. ParkS. S. ParkH. S. ChoiB. H. LeeJ. C. ChoiM. J. NaJ. ParkJ. Y. Kim
Department
Dept. of Internal Medicine (내과학)
Issue Date
2012
Citation
International Journal of Tuberculosis and Lung Disease, Vol.16(6) : 846-851, 2012
ISSN
1027-3719
Abstract
OBJECTIVE: To evaluate the incidence, clinical characteristics and predicting factors for the development of paradoxical response in human immunodeficiency virus negative patients with isolated pleural tuberculosis (TB). DESIGN: A multicentre, retrospective cohort study including 458 patients who were diagnosed and treated with isolated pleural TB between March 2005 and February 2010. RESULTS: Paradoxical response developed in 72 patients (16%) with isolated pleural TB. The mean time to development of paradoxical response was 8.8 ± 6.4 weeks after initiation of anti-tuberculosis treatment. The main presentation of paradoxical response was aggravation of pre-existing pleural effusion in 58 patients (81%). However, the majority of the patients who developed paradoxical response had no associated symptoms (n = 49, 68%). In multiple logistic regression analysis, development of paradoxical response was independently associated with the proportion of eosinophils (adjusted OR 1.293, 95%CI 1.077–1.553) and protein concentrations (adjusted OR 0.590, 95%CI 0.397–0.878) in the pleural fluid at the time of diagnosis. CONCLUSION: Paradoxical response developed in 16% of the patients approximately 2 months after initiation of anti-tuberculosis treatment, presenting with aggravation of pre-existing pleural effusion. Development of paradoxical response was associated with the proportion of eosinophils and protein concentrations in the pleural fluid at the time of diagnosis. KEY WORDS: Mycobacterium tuberculosis; pleural effusion; incidence; risk factors
Keywords
Mycobacterium tuberculosispleural effusionincidencerisk factors
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34477
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
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Full Text
http://www.ingentaconnect.com/content/iuatld/ijtld/2012/00000016/00000006/art00025
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