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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2018  |  Volume : 29  |  Issue : 3  |  Page : 719-722
Multiple tuberculomas invading the central nervous system as a paradoxical reaction in a kidney transplantation recipient


1 Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
2 Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
3 Department of Internal Medicine, Keimyung University School of Medicine, Keimyung University Kidney Institution, Daegu, Korea

Correspondence Address:
Dr. Seungyeup Han
Department of Internal Medicine, Keimyung University School of Medicine, Keimyung University Kidney Institute, Jung-gu, Daegu 41931
Korea
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-2442.235190

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A paradoxical reaction during anti-tuberculosis (anti-TB) therapy is commonly reported in patients with human immunodeficiency virus (HIV). However, a similar reaction to anti-TB therapy can also occur in patients without HIV, especially in patients who have undergone solid organ transplantation. A 65-year-old woman who underwent kidney transplantation six months prior presented to our emergency room with progressive paraparesis. She had been diagnosed with drug-susceptible miliary TB and had undergone two weeks of treatment with anti-TB medication. Magnetic resonance imaging showed a spinal intramedullary mass and multiple intracranial nodules. The etiology of the lesions was confirmed as Mycobacterium tuberculosis. We report a paradoxical reaction of spinal intramedullary and multiple intracranial tuberculomas in a patient with miliary TB who had received appropriate treatment for more than two weeks.


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