Paradoxical Response Developed during the Antituberculous.pdfVIP

결핵흉막염 치료 중에 발생한 역설적 반응에 대한 연구 을지대학교 의과대학 을지병원 내과학교실 송은주, 백대현, 정준영, 이상렬, 이명하, 이성혁, 이재형, 이기덕, 이병훈, 김상훈 Paradoxical Response Developed during the Antituberculous Treatment in Tuberculous Pleurisy Eun Ju Song, M.D., Dae Hyun Baek, M.D., Jun Young Jung, M.D., Sang Ryul Lee, M.D., Myong Ha Lee, M.D., Sung Hyuk Lee, M.D., Jae Hyung Lee, M.D., Ki Deok Lee, M.D., Byoung Hoon Lee, M.D., Sang Hoon Kim, M.D. Department of Internal Medicine, Eulji Hospital, College of Medicine, Eulji University, Seoul, Korea Background: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. Methods: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. Results: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the