Steroids for treating tuberculous pleurisy

Matchaba, Patrice; Volmink, Jimmy

doi:10.1002/14651858.cd001876

Cited by 40 publications

(19 citation statements)

References 14 publications

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“…Although it was observed that there was more rapid resolution of pleural fluid in the prednisolone group after one month, there was no difference seen by the end of the study (46 months) and neither was any difference seen in the degree of residual pleural thickening or lung function [55] Wyser et al in a study of 70 patients in South Africa (34 received prednisolone; 36 received placebos) similarly concluded that there was no benefit seen with corticosteroids in terms of pleural complications such as pleural thickening, lung function impairment or in terms of earlier symptom relief [15]. A Cochrane review in 2000 concluded that there was insufficient evidence to conclude that corticosteroids were effective in tuberculous pleurisy [56].…”

Section: The Role Of Corticosteroids In Tuberculous Pleural Diseasementioning

confidence: 99%

Pleural tuberculosis

Chakrabarti

Davies

2016

Monaldi Arch Chest Dis

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Pleural effusions in tuberculosis are commonly seen in young adults as an immunological phenomenon occurring soon after primary infection. However, the epidemiology and demographics of tuberculous pleurisy are changing due to the impact of HIV co-infection and the increasing number of pleural effusions seen as part of re-activation disease. Pleural biopsy for histology and culture is the mainstay of diagnosis with closed needle biopsy adequate in the majority of cases. Techniques such as PCR of biopsy specimens and the role of pleural fluid ADA are still being evaluated as a diagnostic aid. Tuberculous empyema is less commonly seen in the western world and the diagnostic yield from pleural fluid here is greater than in “primary” effusions. Treatment with appropriate antituberculous chemotherapy is generally successful though there is currently insufficient evidence to recommend the routine use of corticosteroids in this condition.

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Section: The Role Of Corticosteroids In Tuberculous Pleural Diseasementioning

confidence: 99%

Pleural tuberculosis

Chakrabarti

Davies

2016

Monaldi Arch Chest Dis

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“…Neurological deficit or disability was improved among survivors with tuberculous meningitis. There is currently inadequate evidence on whether steroids are effective in tuberculous pleural effusion [241]. In HIV-infected patients, steroids have been shown to be beneficial in tuberculous meningitis, although the overall prognosis is still poor [242].…”

Section: Adjunctive Immunotherapy In Tuberculosismentioning

confidence: 99%

Treatment of tuberculosis: update 2010

Yew¹,

Lange²,

Leung³

2010

European Respiratory Journal

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Currently, the standard short-course chemotherapy for tuberculosis comprises a 6-month regimen, with a four-drug intensive phase and a two-drug continuation phase. Alternative chemotherapy using more costly and toxic drugs, often for prolonged durations generally .18 months, is required for multidrug-resistant and extensively drug-resistant tuberculosis. Directly observed treatment, as part of a holistic care programme, is a cost-effective strategy to ensure high treatment success and curtail development of drug resistance in tuberculosis. New antituberculosis drugs are urgently needed to improve the present standard short-course and alternative chemotherapies, by shortening administration durations and increasing cure rates, through the greater potency of these agents. At the same time, the role of adjunctive surgery for drug-resistant tuberculosis has to be better defined. Immunotherapy might improve treatment outcomes of both drug-susceptible and -resistant tuberculosis, and warrants further exploration.

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“…O uso de corticóide não parece interferir na diminuição das seqüelas ou na evolução da doença, portanto não é recomendado. (29) Níveis elevados no líquido pleural de desidrogenase lática, lisozima e baixos níveis de glicose e pH são preditores de evolução para espessamento pleural.…”

Section: Tratamentounclassified

Tuberculose pleural

2006

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INTRODUÇÃOO comprometimento pleural representa a forma mais freqüente da tuberculose (TB) extrapulmonar. Freqüências variáveis são observadas em diferentes países, de acordo com a prevalência da TB e da sorologia positiva para o vírus da imunodeficiência humana (HIV).(1)A TB pleural pode ser uma manifestação tanto da forma primária da doença (primo-infecção) quanto da reativação de uma infecção latente pelo Mycobacterium tuberculosis. Em ambas a TB pleural está freqüentemente associada à forma pulmonar.(2) Nos países com alta prevalência, a TB ocorre mais em jovens como manifestação da TB primária, enquanto que nos países com baixa pre- RESUMOO derrame pleural tuberculoso pode ser devido a uma manifestação da forma primária da doença ou da reativação de uma infecção latente pelo M. tuberculosis. Os avanços nos métodos laboratoriais contribuíram sobremaneira para um melhor diagnóstico e para a compreensão da fisiopatologia desta doença. No entanto, embora o derrame pleural predominante linfocítico seja indicativo de tuberculose em nosso meio, uma rotina de abordagem diagnóstica deve ser instituída a fim de orientar o tratamento precoce e evitar seqüelas.Descritores: Tuberculose pleural/fisiopatologia; Derrame pleural/fisiopatologia; Tuberculose pleural/epidemiologia; Derrame pleural/epidemiologia; Biopsia ABSTRACTTuberculous pleural effusion is a common manifestation of the primary form of the disease or consequence of the reactivation of a latent infection due to the M. tuberculosis. Advances in the laboratory methods have contributed to better diagnose and understand the pathophysiology of the effusion secondary to tuberculosis. However, although a predominant lymphocytic pleural effusion is suspicious of tuberculosis, a diagnostic routine shall be instituted to orient treatment and prevent undesirable sequels.Keywords: Tuberculosis, pleural/physiopathology; Pleural effusion/physiopathology; Tuberculosis, pleural/epidemiology; Pleural effusion/epidemiology; Biopsy valência ela atinje mais a população idosa, como conseqüência da reativação de um foco de infecção latente, caracterizando a reativação endógena da doença. EPIDEMIOLOGIAEm todo o mundo, cerca de nove milhões de pessoas desenvolvem TB a cada ano. Aproximadamente 80% delas vivem em 22 diferentes países, sendo que o Brasil ocupa o 15º lugar, com cerca de 80 mil casos notificados a cada ano. Em alguns estados, a incidência da doença supera 100 casos por 100 mil habitantes. Além disto, há uma estimativa de 50 milhões de pessoas infectadas.

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Steroids for treating tuberculous pleurisy

Cited by 40 publications

References 14 publications

Pleural tuberculosis

Pleural tuberculosis

Treatment of tuberculosis: update 2010

Tuberculose pleural

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