抗结核治疗完成后出现的矛盾性结核瘤。
Paradoxical tuberculomas after completion of antituberculous treatment.
作者信息
Shah Ira, Borse Shilpa
机构信息
Pediatric TB Clinic, B. J. Wadia Hospital for Children, Mumbai, India.
出版信息
Trop Med Health. 2012 Apr;40(1):15-7. doi: 10.2149/tmh.2011-09c. Epub 2012 Apr 1.
Abstract
Paradoxical reactions in tuberculosis have been reported in patients with tuberculous meningitis and appear as intracranial tuberculomas within 14-270 days of starting antituberculous therapy (ATT). Paradoxical reactions are due to the immune response of the host to ATT. They are commonly seen in the intensive phase of chemotherapy. However, paradoxical reactions occurring after completion of ATT are rare. We report 2 patients with tuberculous meningitis who had already completed ATT and then developed tuberculomas.
摘要
据报道，结核性脑膜炎患者中会出现结核病的矛盾反应，表现为在开始抗结核治疗（ATT）后的14 - 270天内出现颅内结核瘤。矛盾反应是由于宿主对ATT的免疫反应所致。它们常见于化疗的强化期。然而，在ATT完成后出现的矛盾反应很少见。我们报告2例已完成ATT但随后发生结核瘤的结核性脑膜炎患者。
相似文献
1
Paradoxical tuberculomas after completion of antituberculous treatment.抗结核治疗完成后出现的矛盾性结核瘤。
Trop Med Health. 2012 Apr;40(1):15-7. doi: 10.2149/tmh.2011-09c. Epub 2012 Apr 1.
2
En plaque intradural extramedullary spinal tuberculoma and concurrent intracranial tuberculomas: paradoxical response to antituberculous therapy. Case report.椎管内硬脊膜外脊髓结核瘤合并颅内结核瘤：抗结核治疗的矛盾反应。病例报告。
J Neurosurg Spine. 2007 Feb;6(2):169-73. doi: 10.3171/spi.2007.6.2.169.
3
Paradoxical appearance of intracranial tuberculoma in a child with tuberculous meningitis.结核性脑膜炎患儿颅内结核瘤的矛盾表现。
J Trop Pediatr. 2005 Jun;51(3):191-3. doi: 10.1093/tropej/fmi019. Epub 2005 Apr 26.
4
Paradoxical Growth of Optochiasmatic Tuberculoma during the Treatment of Tuberculous Meningitis.结核性脑膜炎治疗期间视交叉结核瘤的矛盾性生长
Curr Health Sci J. 2014 Jul-Sep;40(3):225-7. doi: 10.12865/CHSJ.40.03.14. Epub 2014 Aug 4.
5
Optochiasmatic tuberculomas: a vision-threatening paradoxical response in tuberculous meningitis.视交叉部结核瘤：结核性脑膜炎中一种威胁视力的矛盾反应
Turk Neurosurg. 2012;22(2):246-9. doi: 10.5137/1019-5149.JTN.3279-10.2.
6
Acute respiratory distress during paradoxical reaction to antituberculous therapy in an 8-month-old child.一名8个月大儿童在抗结核治疗的矛盾反应期间出现急性呼吸窘迫。
Lung India. 2012 Oct;29(4):381-3. doi: 10.4103/0970-2113.102840.
7
Paradoxical enlargement of intracranial tuberculomas during treatment of tuberculous meningitis: report of a case.
Taiwan Yi Xue Hui Za Zhi. 1989 Oct;88(10):1067-70.
8
[The cause of paradoxical growth of intracranial tuberculomas during anti-tuberculous chemotherapy].[抗结核化疗期间颅内结核瘤反常生长的原因]
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Nov;27(11):1300-8.
9
Cerebral tuberculoma as a manifestation of paradoxical reaction in patients with pulmonary and extrapulmonary tuberculosis.脑结核瘤作为肺及肺外结核患者反常反应的一种表现。
J Neurosci Rural Pract. 2012 Sep;3(3):350-4. doi: 10.4103/0976-3147.102622.
10
Worsening CSF parameters after the start of anti-tuberculosis treatment predicts intracerebral tuberculoma development.抗结核治疗开始后 CSF 参数恶化预示颅内结核瘤的发展。
Int J Infect Dis. 2020 Dec;101:395-402. doi: 10.1016/j.ijid.2020.09.1457. Epub 2020 Sep 28.
引用本文的文献
1
Late-onset paradoxical response 11 years after treatment of tuberculous hepatic abscesses in an HIV-negative patient: a case report and literature review.一名HIV阴性患者结核性肝脓肿治疗11年后出现迟发性矛盾反应：病例报告及文献综述
Clin J Gastroenterol. 2025 Aug 31. doi: 10.1007/s12328-025-02213-z.
2
Recurrent paradoxical reactions as non-communicating hydrocephalus and basal meningitis in a non-HIV patient with tuberculous meningitis and tuberculoma.一名非艾滋病患者患结核性脑膜炎和结核瘤，出现反复矛盾反应，表现为梗阻性脑积水和基底脑膜炎。
IDCases. 2025 May 1;40:e02237. doi: 10.1016/j.idcr.2025.e02237. eCollection 2025.
3
Intradural extramedullary tuberculoma in a case of disseminated tuberculosis: A case report.播散性肺结核病例中的硬脊膜内髓外结核瘤：一例报告
Surg Neurol Int. 2024 Dec 27;15:477. doi: 10.25259/SNI_664_2024. eCollection 2024.
4
Diagnostic delay in ankle and foot tuberculosis resulting in tuberculoma and tuberculous meningitis in a middle-aged female: A case report.一名中年女性踝关节和足部结核的诊断延误导致结核瘤和结核性脑膜炎：病例报告
SAGE Open Med Case Rep. 2024 Aug 19;12:2050313X241274223. doi: 10.1177/2050313X241274223. eCollection 2024.
5
Post-tuberculosis treatment paradoxical reactions.肺结核治疗后矛盾反应。
Infection. 2024 Oct;52(5):2083-2095. doi: 10.1007/s15010-024-02310-0. Epub 2024 Jul 2.
6
Checklists to guide the supportive and critical care of tuberculous meningitis.指导结核性脑膜炎支持治疗和重症监护的清单。
Wellcome Open Res. 2019 Oct 31;4:163. doi: 10.12688/wellcomeopenres.15512.2. eCollection 2019.
7
Late-onset paradoxical reactions 10 years after treatment for tuberculous meningitis in an HIV-negative patient: a case report.HIV 阴性患者结核性脑膜炎治疗 10 年后出现迟发性矛盾反应：1 例报告。
BMC Infect Dis. 2018 Jul 6;18(1):313. doi: 10.1186/s12879-018-3229-z.
8
Frontal Lobe Tuberculoma: A Clinical and Imaging Challenge.额叶结核瘤：临床与影像学挑战
Ethiop J Health Sci. 2017 Nov;27(6):677-680. doi: 10.4314/ejhs.v27i6.13.
9
Imaging Features of the Brain, Cerebral Vessels and Spine in Pediatric Tuberculous Meningitis With Associated Hydrocephalus.小儿结核性脑膜炎合并脑积水时脑、脑血管及脊柱的影像学特征
Pediatr Infect Dis J. 2016 Oct;35(10):e301-10. doi: 10.1097/INF.0000000000001236.
10
Paradoxical reaction to antitubercular treatment in a case of pulmonary tuberculosis.1例肺结核患者对抗结核治疗的矛盾反应
BMJ Case Rep. 2016 Feb 17;2016:bcr2015214285. doi: 10.1136/bcr-2015-214285.
本文引用的文献
1
Intracranial tuberculomas in patients with tuberculous meningitis: predictors and prognostic significance.结核性脑膜炎患者颅内结核瘤：预测因素及预后意义。
Int J Tuberc Lung Dis. 2011 Feb;15(2):234-9.
2
Intracranial tuberculomas in an immunocompetent patient mimicking brain metastasis of unknown origin.
Infection. 2006 Jun;34(3):181-2. doi: 10.1007/s15010-006-5028-5.
3
Clinical and radiological features of South African patients with tuberculomas of the brain.
Clin Infect Dis. 2000 Aug;31(2):619-20. doi: 10.1086/313989.
4
Paradoxical expansion of intracranial tuberculomas during chemotherapy.化疗期间颅内结核瘤的反常扩大。
J Infect. 1997 Jul;35(1):88-90. doi: 10.1016/s0163-4453(97)91241-x.
5
Cerebral tuberculoma--a comparative study in patients with and without HIV infection.脑结核瘤——HIV感染患者与未感染患者的对比研究
Infection. 1995 May-Jun;23(3):149-53. doi: 10.1007/BF01793855.
6
Tuberculosis of the central nervous system.
Q J Med. 1984 Winter;53(209):81-100.
7
Trends in tuberculosis.结核病的趋势
Postgrad Med J. 1984 Mar;60(701):187-93. doi: 10.1136/pgmj.60.701.187.
8
Paradoxical expansion of intracranial tuberculomas during chemotherapy.化疗期间颅内结核瘤的反常扩大。
Lancet. 1984 Jul 28;2(8396):181-4. doi: 10.1016/s0140-6736(84)90478-1.
9
Cerebral tuberculomas developing during treatment of tuberculous meningitis.结核性脑膜炎治疗期间发生的脑结核瘤。
Lancet. 1980 Jun 7;1(8180):1208-11. doi: 10.1016/s0140-6736(80)91676-1.
10
Zotero 插件