Infliximab for Paradoxical Reactions in Pediatric Central Nervous System Tuberculosis.
Yara-Natalie Abo1, Nigel Curtis1,2,3, Joshua Osowicki1,2,3
1Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Journal of the Pediatric Infectious Diseases Society
|October 5, 2021
Summary
Severe paradoxical reactions in central nervous system tuberculosis (CNS-TB) in children can be effectively treated with infliximab when corticosteroids fail. This approach offers a promising alternative for managing this serious complication.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Paradoxical reactions complicate treatment for central nervous system tuberculosis (CNS-TB).
- These reactions are linked to increased illness and death.
- Corticosteroids are a common treatment, but not always effective.
Purpose of the Study:
- To report on the use of infliximab in children with severe CNS-TB paradoxical reactions.
- To evaluate the safety and effectiveness of infliximab in this patient group.
Main Methods:
- Case series describing 4 HIV-uninfected children with CNS-TB.
- Children experienced severe paradoxical reactions unresponsive to corticosteroids.
- Treatment with infliximab was administered.
Main Results:
- All 4 children recovered after receiving infliximab.
- Infliximab was found to be safe and effective in these cases.
- No adverse events were reported.
Conclusions:
- Infliximab is a potential treatment for severe corticosteroid-unresponsive paradoxical reactions in pediatric CNS-TB.
- Further prospective studies are needed to confirm these findings.
- This highlights a novel therapeutic option for a challenging complication.
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