title: Paradoxical reactions in children with tuberculosis.
abstract: We sought to determine the incidence and clinical spectrum of the paradoxical reaction (PR) to treatment in 1000 children with tuberculosis (TB). Its incidence was 3.3%, presenting as mediastinal adenopathy (n = 12), central nervous system (CNS) tuberculoma (n = 8), increasing size of lymph nodes (n = 8) and serositis (n = 5). Symptoms included breathlessness (n = 7, 21.2%), neck swellings (n = 5, 15.2%), hemiplegia (n = 3, 9.1%), raised intracranial tension (n = 2, 6.1%) and fever or diabetes insipidus (n = 1, 3% each). The mean age of onset of PR was 3.5 months after the start of anti-TB medication. PR was seen predominantly in boys. Mediastinal lymphadenopathy was more common in children aged <2 years. Tuberculomas were more common in children aged 2-5 years. Nodal enlargement and serositis were seen equally in all age groups.
authors.affiliation: Paediatric TB Clinic, BJ Wadia Hospital for Children, Mumbai, India.
authors.forename: Ira
authors.initials: I
authors.lastname: Shah
authors.affiliation: Paediatric TB Clinic, BJ Wadia Hospital for Children, Mumbai, India.
authors.forename: M V
authors.initials: MV
authors.lastname: Bhaskar
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D014375:Tuberculoma / Q000473:pathology; D014376:Tuberculosis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000995:Antitubercular Agents
keywords: Tuberculosis; children; diabetes insipidus; paradoxical reaction; serositis; tuberculoma