Paradoxical response in HIV-negative patients with pleural tuberculosis: a retrospective multicentre study
- Authors
- Jeon, K.; Choi, W-I.; An, J. S.; Lim, S. Y.; Kirn, W. J.; Park, G. M.; Park, S. S.; Choi, H. S.; Lee, B. H.; Choi, J. C.; Na, M. J.; Park, J.; Kim, J. Y.
- Issue Date
- Jun-2012
- Publisher
- INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
- Keywords
- Mycobacterium tuberculosis; pleural effusion; incidence; risk factors
- Citation
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, v.16, no.6, pp 846 - 851
- Pages
- 6
- Journal Title
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
- Volume
- 16
- Number
- 6
- Start Page
- 846
- End Page
- 851
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/20275
- DOI
- 10.5588/ijtld.11.0642
- ISSN
- 1027-3719
1815-7920
- 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%Cl 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.
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