Adjunctive Effects of Oral Steroids Along with Anti-Tuberculosis Drugs in the Management of Cervical Lymph Node Tuberculosis

• Main Authors: Babulal Bansiwal, Maneesha Jelia, Ramesh Chand Meena, Satyam Agarwal, Shinu A
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2021-01-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: corticosteroids; steroids; tuberculosis; extrapulmonary tuberculosis; treatment; lymphadenitis; scrofula; symptoms; antituberculosis treatment; prednisolone
• Online Access: https://www.swjpcc.com/pulmonary/2021/1/10/adjunctive-effects-of-oral-steroids-along-with-anti-tubercul.html

Background: Tuberculosis (TB) can infect both pulmonary and extra-pulmonary organs. In India pulmonary TB accounts for 80% of cases and extrapulmonary TB (EPTB) accounts for 20% cases. Cervical lymph nodes are the most location for EPTB. Aims and Objectives: To study the efficacy of treatment with oral steroids along with anti-tuberculosis treatment in cervical lymph node tuberculosis. Methods: A total of 60 patients were enrolled in the study all with EPTB and cervical lymphadenitis. These 60 study patients were randomised into two groups. Group-I consisted of 30 patients given anti-tuberculosis therapy along with prednisolone 1mg/kg body weight for 4 weeks followed by tapering at 0.5 mg/kg body weight over 4 weeks. Group-II was comprised of 30 patients given antituberculosis treatment plus placebo Results: After completion of treatment 27 patients in Group I (90%) showed complete resolution and 3 patients (10%) had residual evidence of lymphadenitis with no change. In contrast, only 19 patients (63.3%) showed complete resolution in Group 2 and 11 patients (36.7%) had residual lymphadenitis present (10 had no change, 1 had increase in size). Conclusion: We conclude that steroids given with antituberculosis treatment to patients with cervical lymphadenitis led to faster and earlier resolution of tuberculous lymphadenitis.