Acute lymphoid leukemia and pott mal: Paradoxical response to antitbc treatment

Leucemia linfoide aguda y mal de pott: Respuesta paradójica al tratamiento antitbc

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Gómez, C. H., Vargas, V., Alfonso, C. A., Vásquez, L., Casas, C. P., Abello, V., & Jiménez, A. (2015). Acute lymphoid leukemia and pott mal: Paradoxical response to antitbc treatment. Journal of Medicine and Surgery Repertoire, 24(3), 226–230. https://doi.org/10.31260/RepertMedCir.v24.n3.2015.621
Published: Sep 1, 2015
Doi
https://doi.org/10.31260/RepertMedCir.v24.n3.2015.621
Issue
Vol. 24 No. 3 (2015): July - September
Section
Case Reports
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Carlos Hernando Gómez
Viviana Vargas
Camilo Andrés Alfonso
Leonidas Vásquez
Claudia Patricia Casas
Virginia Abello
Adriana Jiménez

Abstract

A 58-year-old man with a diagnosis of acute lymphoid leukemia who underwent transplantation of peripheral blood progenitors from an intrafamilial donor. It required immunosuppressive management due to the presence of acute and chronic graft versus host disease. He consulted for severe lumbar pain and in the examinations were found compatible lesions with spondylodiscitis L4-L5 and paravertebral collections. With suspicion of tuberculosis, empirical treatment was started, the initial clinical evolution was torpid due to persistent symptoms and progressive neurological compromise, for which the presence of atypical vs resistant mycobacteria was suspected. Isolation of Mycobacterium tuberculosis susceptible to the established therapy was achieved. TBC treatment scheme with clinical evolution to improvement was continued. It was interpreted as a paradoxical reaction to the therapy, but with the presence of a renal lesion in which a relapse of the haematological disease was confirmed. Abbreviations: TB, tuberculosis.

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References

1. Cheung WY, Luk KD. Clinical and radiological outcomes after conservative treatment of TB spondylitis: is the 15 years’ follow-up in the MRC study long enough?. Eur Spine J. 2013 Jun; 22 Suppl 4:594-602.

2. Akan H, Arslan O, Akan OA. Tuberculosis in stem cell transplant patients. J Hosp Infect. 2006 Apr; 62(4):421-6.

3. Cheng VC, Yuen KY, Chan WM, Wong SS, Ma ES, Chan RM. Immunorestitution disease involving the innate and adaptive response. Clin Infect Dis. 2000 Jun; 30(6):882-92.

4. Chambers ST, Hendrickse WA, Record C, Rudge P, Smith H. Paradoxical expansion of intracranial tuberculomasduring chemotherapy. Lancet. 1984 Jul 28; 2(8396):181-4.

5. Malik GM, Mubarik M, Basu JA, Kadla SA, Hussain T, Rashid S. Paradoxical expansion of cerebral tuberculomas during therapy for Pott’s spine. J R Soc Med. 1996 Nov; 89(11):643-4.

6. Al-Majed SA. Study of paradoxical response to chemotherapy in tuberculous pleural effusion. Respir Med. 1996 Apr; 90(4):211-4.

7. Lizarazo J. Aparición paradójica de tuberculomas encefálicos durante el tratamiento de tuberculosis en pacientes inmunocompetentes. Biomédica. 2004; 24(Supl.): 34-42.

8. Cheng VC, Ho PL, Lee RA, Chan KS, Chan KK, Woo PC, et al. Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. Eur J Clin Microbiol Infect Dis. 2002; 21(11): 803-9.

9. Bukharie H. Paradoxical response to anti-tuberculosis drugs: resolution with corticosteroid therapy. Scand J Infect Dis. 2000; 32(1):96-7.

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