Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of newly developed pulmonary lesion during the antitubercular agents in tuberculous pleurisy : A paradoxical response

결핵흉막염 치료중에 새로이 발생한 폐병변 1예 : 역설적 반응

  • Park, Jee Min (Department of Pediatrics, Ajou University School of Medicine) ;
  • Shin, Youn Ho (Department of Pediatrics, Pochon CHA University, College of Medicine) ;
  • Chon, Gyu Rak (Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine Konkuk University College of Medicine) ;
  • Shin, Hyun Joon (Department of Radiology, Konkuk University College of Medicine) ;
  • Choi, Young Chil (Department of Radiology, Konkuk University College of Medicine)
  • 박지민 (아주대학교 의과대학 소아과학교실) ;
  • 신윤호 (포천중문의과대학 소아과학교실) ;
  • 전규락 (건국대학교 충주병원 내과학교실) ;
  • 신현준 (건국대학교 충주병원 방사선과교실) ;
  • 최영칠 (건국대학교 충주병원 방사선과교실)
  • Received : 2009.03.20
  • Accepted : 2009.05.19
  • Published : 2009.06.15
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Abstract

Paradoxical response refers to the enlargement of old lesions or unexpected appearance of new lesions after initial improvement following treatment with antitubercular agents. Various types of paradoxical responses have been reported in the world, but they are rarely reported in Korean children. We report the case of a 17-year-old boy who was diagnosed with tuberculous pleurisy and was treated appropriately. Although the tuberculous pleurisy initially responded to medication with resolution of the pleural fluid, a new pulmonary lesion subsequently developed 3 weeks after the initiation of treatment that eventually cleared with continuation of the original drug regimen.

결핵 환자들에서 역설적반응이란 항결핵제 치료 중 초기에 병변의 호전 이후 방사선학적, 임상적으로 이전의 병변이 악화되거나 새로운 병변이 발생하는 경우로 정의될 수 있다. 전세계적으로 지금까지 다양한 종류의 역설적 반응이 보고되어 왔다. 그러나 국내 소아에서의 보고는 거의 드물다. 이에 저자들은 17세 남아에서 결핵성 흉막삼출로 진단되어 결핵약물에 좋은 반응을 보여 적절한 치료 후 흉수가 호전된 후에, 첫 치료 3주 후에 새로이 발생한 폐병변이 기존의 항결핵제를 계속하면서 결국에는 호전된 케이스를 경험하였기에 보고하는 바이다.

Keywords

References

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