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Clinical perspectives into the use of thalidomide for central nervous system tuberculosis.

08:00 EDT 23rd June 2018 | BioPortfolio

Summary of "Clinical perspectives into the use of thalidomide for central nervous system tuberculosis."

Central nervous system (CNS) tuberculosis (TB) accounts for over 4% of all TB notifications in the United Kingdom, and causes death or significant disability in over half of those affected. TNF-alpha is a critical cytokine involved in the neuropathogenesis of CNS TB. Thalidomide has been trialled in CNS TB due to its immunomodulatory and immune reconstitution effects, through inhibition of TNF-alpha. Despite animal models demonstrating dramatic improvement in survival, studies in paediatric patients have been associated with higher levels of mortality. The effects of thalidomide have not yet been studied in adults with CNS TB. This narrative case series guides clinicians through a range of CNS TB clinical cases seen in a large London teaching hospital, serving a region with a high TB incidence of 32 per 100,000, with 55% of TB manifesting as extrapulmonary disease. We aim to illustrate our experiences of using thalidomide to treat a range of severe CNS TB complications.

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This article was published in the following journal.

Name: European journal of neurology
ISSN: 1468-1331
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Medical and Biotech [MESH] Definitions

Tuberculosis of the brain, spinal cord, or meninges (TUBERCULOSIS, MENINGEAL), most often caused by MYCOBACTERIUM TUBERCULOSIS and rarely by MYCOBACTERIUM BOVIS. The infection may be limited to the nervous system or coexist in other organs (e.g., TUBERCULOSIS, PULMONARY). The organism tends to seed the meninges causing a diffuse meningitis and leads to the formation of TUBERCULOMA, which may occur within the brain, spinal cord, or perimeningeal spaces. Tuberculous involvement of the vertebral column (TUBERCULOSIS, SPINAL) may result in nerve root or spinal cord compression. (From Adams et al., Principles of Neurology, 6th ed, pp717-20)

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