[Paradoxical tuberculosis reaction].
Réaction paradoxale tuberculeuse.
Anti-TNF
Corticosteroid
Corticoïdes
Granulomatose
Granulomatosis
Immune reconstitution inflammatory syndrome
Paradoxical reaction
Réaction paradoxale
Syndrome inflammatoire de reconstitution immune
Tuberculose
Tuberculosis
Journal
La Revue de medecine interne
ISSN: 1768-3122
Titre abrégé: Rev Med Interne
Pays: France
ID NLM: 8101383
Informations de publication
Date de publication:
23 Jan 2024
23 Jan 2024
Historique:
received:
23
07
2023
revised:
20
12
2023
accepted:
09
01
2024
medline:
25
1
2024
pubmed:
25
1
2024
entrez:
24
1
2024
Statut:
aheadofprint
Résumé
Paradoxical tuberculosis reaction is defined as the aggravation of lesions present at diagnosis or the development of new lesions under anti-tuberculosis treatment, after exclusion of other alternate causes. It affects 5 to 30% of tuberculosis patients, with a variable prevalence depending on the site of infection and the clinical background. The diagnosis of paradoxical reaction is one of elimination, and requires having ruled out therapeutic failure, notably linked to poor compliance and/or to the presence of mycobacterial antibiotic resistance. The severity of paradoxical tuberculosis reaction lies in its neurological impairment. Despite its clinical importance, the mechanisms involved remain poorly understood and its management is not consensual. Corticosteroids are the cornerstone in the medical management. The role of anti-TNF agents, currently proposed in cases of corticodependence or corticoresistance, remains to be properly defined.
Identifiants
pubmed: 38267320
pii: S0248-8663(24)00028-6
doi: 10.1016/j.revmed.2024.01.008
pii:
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
fre
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.