Linked Life Data

15163089

Source:http://linkedlifedata.com/resource/pubmed/id/15163089

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2004-5-27
pubmed:abstractText
Childhood tuberculous meningitis is associated with serious long-term sequelae, including mental retardation, behavior disturbances, and motor handicap. Brain damage in tuberculous meningitis results from a cytokine-mediated inflammatory response, which causes vasculitis and obstructive hydrocephalus. Thalidomide, a potent tumor necrosis factor alpha inhibitor, was well tolerated and possibly showed some clinical benefit in children with tuberculous meningitis during a pilot study. The purpose of the present study was to assess the effect of adjunctive thalidomide in addition to standard antituberculosis and corticosteroid therapy on the outcome of tuberculous meningitis. Thalidomide (24 mg/kg/day orally) or placebo was administered in a double-blind randomized fashion for 1 month to patients with stage 2 or 3 tuberculous meningitis. The study was terminated early because all adverse events and deaths occurred in one arm of the study (thalidomide group). Thirty of the 47 children enrolled received adjunctive thalidomide, of whom 6 (20%) developed a skin rash, 8 (26%) hepatitis, and 2 (6%) neutropenia or thrombocytopenia. Four deaths (13%) occurred in patients with very severe neurologic compromise at baseline; two deaths were associated with a rash. Motor outcome after 6 months of antituberculosis therapy was similar in the two groups, even though the thalidomide group showed greater neurologic compromise on admission. In addition, the mean IQ of the two treatment groups did not differ significantly (mean IQ thalidomide group 57.8 versus mean IQ control group 67.5; P = .16). These results do not support the use of adjunctive high-dose thalidomide therapy in the treatment of tuberculous meningitis.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0883-0738
pubmed:author
pubmed:issnType
Print
pubmed:volume
19
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
250-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:15163089-Adrenal Cortex Hormones, pubmed-meshheading:15163089-Anti-Inflammatory Agents, pubmed-meshheading:15163089-Antitubercular Agents, pubmed-meshheading:15163089-Chemotherapy, Adjuvant, pubmed-meshheading:15163089-Child, pubmed-meshheading:15163089-Child, Preschool, pubmed-meshheading:15163089-Cohort Studies, pubmed-meshheading:15163089-Coma, pubmed-meshheading:15163089-Cytokines, pubmed-meshheading:15163089-Double-Blind Method, pubmed-meshheading:15163089-Exanthema, pubmed-meshheading:15163089-Hepatitis, pubmed-meshheading:15163089-Humans, pubmed-meshheading:15163089-Immunosuppressive Agents, pubmed-meshheading:15163089-Infant, pubmed-meshheading:15163089-Intelligence, pubmed-meshheading:15163089-Paresis, pubmed-meshheading:15163089-South Africa, pubmed-meshheading:15163089-Statistics, Nonparametric, pubmed-meshheading:15163089-Thalidomide, pubmed-meshheading:15163089-Treatment Outcome, pubmed-meshheading:15163089-Tuberculosis, Meningeal
pubmed:year
2004
pubmed:articleTitle
Adjunctive thalidomide therapy for childhood tuberculous meningitis: results of a randomized study.
pubmed:affiliation
Department of Pediatrics and Child Health, Tygerberg Children's Hospital, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa. jfs@sun.ac.za
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial