Controlled Clinical Trial of Complete Open Surgical Drainage and of Prednisolone in Treatment of Tuberculous Pericardial Effusion in Transkei

Strang, J.I.G.; Gibson, D G; Mitchison, D. A.; Girling, D J; Kakaza, H.H.S.; Allen, B.W.; Evans, David; Nunn, AJ; Fox, Wallace

doi:10.1016/s0140-6736(88)92415-4

Cited by 188 publications

(130 citation statements)

References 14 publications

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“…In one large scale prospective South African study, oral prednisolone appeared to reduce the risk of reaccumulation of pericardial fluid, and the requirement for repeat pericardiocentesis, with a trend towards reduced mortality. 31 Furthermore, the use of prednisolone in patients with established pericardial constriction was associated with a (non-significantly) lower mortality from pericarditis and a reduced requirement for pericardectomy. 32 Although the use of steroids remains controversial, 33 our practice is still to use adjuvant prednisolone in all patients treated with antituberculous chemotherapy for tuberculous pericarditis.…”

Section: Discussionmentioning

confidence: 99%

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

et al. 2000

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The aim of the study was to determine the aetiology of large and symptomatic pericardial eVusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial eVusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of AfroCaribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an eVective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low. (Postgrad Med J 2000;76:809-813)

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Section: Discussionmentioning

confidence: 99%

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

et al. 2000

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“…If not conveniently emptied, it will evolve to formation of fibrin, septation and granuloma with adherence and thickening of leaflets, developing to constrictive chronic pericarditis. Corticoids are known to be beneficial, hindering liquid re-accumulation, but the literature still lacks data on the prevention of constrictive pericarditis (7) . The complete and permanent drainage of the effusion liquid would be the best way to avoid future constriction of the heart chambers (8) .…”

Section: Discussionmentioning

confidence: 99%

Tuberculous pericarditis in acquired immune deficiency syndrome patients

Guidugli¹,

Hamrick²,

Rezende³

2003

J. Pneumologia

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Two quite dyspneic HIV positive patients were admitted to the Emergency Room; they presented clinical signs and images suggesting pericardial effusion. The analysis of an initial liquid puncture did not show any specificity and the patients did not exhibit any clinical improvement. Both patients were submitted to a subxiphoid pericardial window, all the effusion liquid was drained, and a biopsy of the pericardium tissue was completed, revealing a granulomatous process. Immediately after the onset of specific treatment, the patients showed a good evolution. Such findings draw attention to a high possibility of pericardial suffusion in AIDS patients being tuberculosis, particular if one considers the high prevalence of this disease in Brazil. The results also showed that the opening of a subxiphoid pericardial window and the specific triple scheme was a procedure that led to good therapeutic evolution in these patients. (J Pneumol J Pneumol J Pneumol J Pneumol 2003;29(2):98-100)

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“…Based on systematic reviews conducted in support of the guidelines, greatly informed by a recent placebo-controlled randomised clinical trial with 1400 participants [46], adjunctive corticosteroids should not be used routinely in the treatment of patients with pericardial TB (PICO question 7) [46][47][48][49][50]. However, selective use of corticosteroids in patients who are at the highest risk for inflammatory complications might be appropriate.…”

Section: Tb Pericarditismentioning

confidence: 99%

The ERS-endorsed official ATS/CDC/IDSA clinical practice guidelines on treatment of drug-susceptible tuberculosis

et al. 2016

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Controlled Clinical Trial of Complete Open Surgical Drainage and of Prednisolone in Treatment of Tuberculous Pericardial Effusion in Transkei

Cited by 188 publications

References 14 publications

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

Tuberculous pericarditis in acquired immune deficiency syndrome patients

The ERS-endorsed official ATS/CDC/IDSA clinical practice guidelines on treatment of drug-susceptible tuberculosis

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