ReviewMedicine2020
Tumor necrosis factor antagonists for paradoxical inflammatory reactions in the central nervous system tuberculosis: Case report and review.
Review in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- Inflammation Precedes Paradoxical Reactions in HIV-Negative Patients With Pulmonary Tuberculosis.Open forum infectious diseases · 2026Article
- Miliary Tuberculosis: A Comprehensive Review of Epidemiology, Clinical Manifestations, Diagnosis, Treatment, and Complications.Infection and drug resistance · 2026Review
- Thalidomide-mediated immunomodulation in a patient withFrontiers in immunology · 2026Article
- Standardized Infliximab Regimen to Treat Severe Central Nervous System Tuberculosis: A Case Series of 18 Patients.Open forum infectious diseases · 2025Article
- Potential of Neuroinflammation-Modulating Strategies in Tuberculous Meningitis: Targeting Microglia.Aging and disease · 2024Review
- A teenage girl with altered mental status and paraparesis.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Successful rescue TNF-α blocking forHeliyon · 2024Article
- Infliximab for Intractable Paradoxical Reaction in Culture-Negative Tuberculosis Meningitis.Journal of clinical neurology (Seoul, Korea) · 2024Article
- The use of TNF-α antagonists in tuberculosis to control severe paradoxical reaction or immune reconstitution inflammatory syndrome: a case series and literature review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Review
- Pelvic and central nervous system tuberculosis complicated by a paradoxical response manifesting as a spinal tuberculoma: a case report.BMC infectious diseases · 2022Article
- CNS TB-IRIS Following Cessation of Adalimumab in an Adolescent With Crohn's Disease.Open forum infectious diseases · 2022Article
- Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleParadoxical reaction/immune reconstitution inflammatory syndrome is common in patients with central nervous system tuberculosis. Management relies on high-dose corticosteroids and surgery when feasible. PATIENT CONCERN: We describe 2 cases of HIV-negative patients with corticosteroid-refractory paradoxical reactions of central nervous system tuberculosis. DIAGNOSES: The 2 patients experienced clinical impairment shortly after starting therapy for TB, and magnetic resonance imaging showed the presence of tuberculomas, leading to the diagnosis of a paradoxical reaction.
interventionsWe added infliximab, an anti-tumor necrosis factor (TNF)-alpha monoclonal antibody, to the dexamethasone. OUTCOMES: Both patients had favorable outcomes, 1 achieving full recovery but 1 suffering neurologic sequelae. LESSONS: Clinicians should be aware of the risk of paradoxical reactions/immune reconstitution inflammatory syndrome when treating patients with tuberculosis of the central nervous system and should consider the prompt anti-TNF-α agents in cases not responding to corticosteroids.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.