Table 5. Comparison of characteristics according to paradoxical response during treatment in patients who completed anti-TB treatment (n = 125).
| Characteristics | Non-PR group (n = 104) | PR group (n = 21) | P value | ||
|---|---|---|---|---|---|
| Age, yr | 61 (50–72) | 47 (30–55) | 0.001 | ||
| Age, < 55 yr | 35 (34) | 15 (71) | 0.001 | ||
| Sex, male | 51 (49) | 10 (48) | 0.906 | ||
| BMI, kg/m2 | 23.1 (20.7–25.0) | 22.8 (20.0–26.3) | 0.942 | ||
| BMI, < 18.5 kg/m2 | 9 (9) | 1 (5) | 1.000 | ||
| Ever smoked | 33 (32) | 10 (48) | 0.162 | ||
| Previous history of TB treatment | 10 (10) | 4 (19) | 0.252 | ||
| Comorbidities | 67 (64) | 10 (48) | 0.149 | ||
| Symptoms | |||||
| Thoracic symptoms | 33 (32) | 12 (57) | 0.027 | ||
| Constitutional symptoms | 21 (20) | 11 (52) | 0.002 | ||
| Laboratory findings | |||||
| White blood cells, /µL | 5,795 (4,923–7,275) | 6,570 (5,590–7,550) | 0.074 | ||
| Neutrophils, /µL | 3,302 (2,573–4,528) | 4,124 (3,031–5,192) | 0.066 | ||
| Neutrophils, > 4,000/µL | 35 (34) | 13 (62) | 0.015 | ||
| Lymphocytes, /µL | 1,711 (1,263–2,080) | 1,518 (1,008–2,026) | 0.298 | ||
| Lymphocytes, < 800/µL | 4 (4) | 4 (19) | 0.027 | ||
| Erythrocyte sedimentation rate, mm/h | 31 (13–56) | 46 (21–73) | 0.039 | ||
| Erythrocyte sedimentation rate, > 40 mm/h | 35 (34) | 12 (57) | 0.043 | ||
| C-reactive protein, mg/dL | 0.3 (0.1–1.3) | 0.9 (0.2–2.1) | 0.028 | ||
| C-reactive protein, > 0.4 mg/dL | 43 (41) | 14 (67) | 0.034 | ||
| Coexisting TB | |||||
| Pulmonary TB | 37 (36) | 9 (43) | 0.528 | ||
| Extrapulmonary TBa | 26 (25) | 10 (48) | 0.037 | ||
| Diagnostic methods | |||||
| Smear-positive | 1/104 (1) | 1/20 (5) | 0.298 | ||
| Culture-positive | 80/104 (77) | 14/20 (70) | 0.570 | ||
| MTB PCR-positive | 36/104 (35) | 9/21 (43) | 0.473 | ||
| Histopathologic confirmation | 28/104 (27) | 6/21 (29) | 0.877 | ||
| Positive results in the rinse fluid only | 53 (51) | 7 (33) | 0.140 | ||
| CT findings for mediastinal LNTB | |||||
| Number of TB-suspected LNsb | 3 (1–4) | 4 (2–5) | 0.065 | ||
| Long axis diameter of the largest LN, mmc | 23 (18–30) | 25 (20–34) | 0.292 | ||
| Short axis diameter of the largest LN, mmc | 13 (11–18) | 18 (15–23) | 0.007 | ||
| Any resistance to anti-TB drugs | 10 (10) | 2 (10) | 1.000 | ||
| Complications due to TB at the time of diagnosis | 1 (1) | 2 (10) | 0.073 | ||
| Simultaneously diagnosed with lung cancer | 16 (15) | 3 (14) | 1.000 | ||
| Management for lung cancer | |||||
| Lung resection | 11/16 (69) | 3/3 (100) | 0.530 | ||
| Chemotherapy | 5/16 (31) | 1/3 (33) | 1.000 | ||
| Radiotherapy | 2/16 (13) | 0/3 (0) | 1.000 | ||
| Chemotherapy for cancers other than lung cancer | 7 (7) | 1 (5) | 1.000 | ||
Data are reported as median (interquartile range) and number (%). There was no recurrence of TB during the follow-up period up to the time of data collection (median 20.9 months after the treatment initiation).
TB = tuberculosis, PR = paradoxical response, BMI = body mass index, MTB = Mycobacterium tuberculosis, PCR = polymerase chain reaction, CT = computed tomography, LNTB = lymph node tuberculosis, LN = lymph node.
aOther than mediastinal LNs.
bThis includes (1) cases in which necrosis was seen inside the LN on contrast-enhanced CT, or (2) the short diameter of the LN was 10 mm or more, even though no biopsy was performed, and (3) cases confirmed as TB as a result of the biopsy.
cThe largest LN was determined based on the short axis diameter.