Document Detail

Recovery of vision after adjuvant thalidomide in a child with tuberculous meningitis and acute lymphoblastic leukemia.
MedLine Citation:
PMID:  19182153     Owner:  NLM     Status:  MEDLINE    
A 7-year-old child, on maintenance chemotherapy for acute lymphoblastic leukemia, developed tuberculous meningitis complicated by progressive basal meningeal inflammation and abscess formation, in spite of adequate tuberculosis treatment and adjunctive corticosteriod therapy. The child became blind as a result of involvement of the optic chiasm. After 2 months of adjunctive thalidomide therapy, the child regained vision and cranial magnetic resonance imaging showed marked reduction of the inflammatory changes previously demonstrated. Progression of intracranial tuberculous infection, in spite of a treatment that is generally considered to be adequate, is well recognized. Previous reports of a possible beneficiary role of thalidomide in these cases support an immunological basis. The present case suggests a role for thalidomide in the treatment of blindness due to involvement of the optic chiasm in progressive basal tuberculous meningitis.
Daniela Cristina Stefan; Savvas Andronikou; Nicola Freeman; Johan Schoeman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of child neurology     Volume:  24     ISSN:  1708-8283     ISO Abbreviation:  J. Child Neurol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606714     Medline TA:  J Child Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  166-9     Citation Subset:  IM    
Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Tygerberg Children's Hospital, Cape Town, South Africa.
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Blindness / drug therapy*,  etiology
Brain / drug effects,  pathology
Chemotherapy, Adjuvant
Immunosuppressive Agents / therapeutic use
Magnetic Resonance Imaging
Optic Chiasm / drug effects,  physiopathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*,  drug therapy,  physiopathology
Recovery of Function / drug effects
Thalidomide / therapeutic use*
Tuberculosis, Meningeal / complications*,  pathology,  physiopathology
Vision, Ocular / drug effects*
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Immunosuppressive Agents; 50-35-1/Thalidomide

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