2009
DOI: 10.1016/j.ijid.2008.04.003
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Two cases of bacterial meningitis accompanied by thalidomide therapy in patients with multiple myeloma: is thalidomide associated with bacterial meningitis?

Abstract: Morbidity and mortality in multiple myeloma is often attributed to life-threatening infections. A defect in humoral immunity has been proposed for the predisposition to bacterial infections. Most of the infections are of bacterial origin, and the most serious are septicemia, meningitis, and pneumonia. Thalidomide is a drug with pleiotropic effects. The immunomodulatory effects of thalidomide are at least partially mediated through its ability to down-regulate the pathogenic over-production of tumor necrosis fa… Show more

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Cited by 5 publications
(3 citation statements)
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“…Tumor necrosis factor-alpha (TNF-α) is a cytokine that plays a central role in the regulation of host immune and inflammatory response to infection. In the central nervous system, TNF-α is involved in induction of a fever response and triggers the release of other cytokines, and may also influence transport of compounds into the brain, leading to cerebrospinal fluid leukocytosis, increased protein influx, and lactate accumulation [ 21 ]. Cytokines regulate function of many cells in an additive, synergistic or antagonistic manner.…”
Section: Discussionmentioning
confidence: 99%
“…Tumor necrosis factor-alpha (TNF-α) is a cytokine that plays a central role in the regulation of host immune and inflammatory response to infection. In the central nervous system, TNF-α is involved in induction of a fever response and triggers the release of other cytokines, and may also influence transport of compounds into the brain, leading to cerebrospinal fluid leukocytosis, increased protein influx, and lactate accumulation [ 21 ]. Cytokines regulate function of many cells in an additive, synergistic or antagonistic manner.…”
Section: Discussionmentioning
confidence: 99%
“…Patients with MM have abnormalities in both cellular and humoral immunity that increase the risk of infection. Those defects include hypogammaglobulinemia, low number and anomalous function of dendritic and T cells, abnormal Th1/Th2 CD4 + ratio, disruption of T cell diversity, and dysfunction of natural killer cells [ [14] , [15] ]. MM treatment also increases the risk for infections, cytopenias, and thrombotic events [ [16] , [17] , [18] , [19] ].…”
Section: Discussionmentioning
confidence: 99%
“…Thus, higher local drug concentrations may inhibit the growth of MM cells. Clinically, MM patients are highly susceptible to serious infections due to immunodeficiency [33, 34]. Chloramphenicol may be used to control infections in these patients as well as to suppress their tumors.…”
Section: Discussionmentioning
confidence: 99%