Pauranik A, Behari M, Maheshwari M C
Department of Neurology, All India Institute of Medical Sciences, New Delhi.
Jpn J Med. 1987 Aug;26(3):332-4. doi: 10.2169/internalmedicine1962.26.332.
Case histories of two young Indian female patients are described who, during the course of regular chemotherapy for tuberculous meningitis, developed tuberculoma as suggested by CT-scan. Such lesions were not seen at the start of treatment. Twelve similar cases are collected from literature. Most of the patients developed new symptoms and/or signs having initially shown good response to drugs. The pathogenetic mechanisms for such an evolution of lesions are not known but possibly include immunological modulations. This development should not lead to excessive anxiety for treating physician. Surgery is not needed and a patient follow up is well rewarded. Pyrazinamide has emerged as a useful drug.
描述了两名年轻印度女性患者的病历，她们在结核性脑膜炎的常规化疗过程中，经CT扫描显示出现了结核瘤。治疗开始时未发现此类病变。从文献中收集了12例类似病例。大多数患者最初对药物表现出良好反应，但后来出现了新的症状和/或体征。这种病变演变的发病机制尚不清楚，但可能包括免疫调节。这种情况不应导致治疗医生过度焦虑。不需要手术，对患者进行随访会有很好的回报。吡嗪酰胺已成为一种有用的药物。
