Add-on prednisolone in the management of cervical lymph node tuberculosis

Bunkar, Moti Lal; Agnihotri, Shashi Prakash; Gupta, Prahlad Ral; Arya, Shalini S.

doi:10.1016/j.ijtb.2015.05.002

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…Specifically, for neuro-TB, the administration of corticosteroids reduces cerebral edema by also influencing cerebral vasculature [43], while for peripheral lymph node TB, the benefit of corticosteroid therapy seems to be less clear [44]. Nonetheless, a more recent comparative study showed that the routine addition of corticosteroids for the first 3-4 months in tapering dosage, even without appearance of paradoxical reaction, in patients receiving standard medication for cervical lymph node tuberculosis, is safe with better clinical outcome and complete relief of symptoms [38].…”

Section: Discussionmentioning

confidence: 99%

Left Lateral Cervical Mass with Draining Sinuses

Michaelides

Bablekos

Michailidis

et al. 2019

Case Reports in Medicine

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The aim of the present study is to describe an uncommon case of tuberculous lymphadenitis (TL) in a symptomless 89-year-old male smoker patient, who presented at the emergency department of our hospital with left lateral cervical swelling with draining sinuses. No other clinical symptoms or physical findings were observed at admission. An elevated erythrocyte sedimentation rate (ESR) and a small calcified nodule in chest CT were the only abnormal findings. Pus samples from sinuses were examined and confirmed tuberculosis which was in agreement with surgical pathology of lymph nodes. A four- (4-) drug antituberculous regimen was administered. After an initial remission of his symptoms, the patient presented an exacerbation of the cervical swelling with draining sinuses necessitating addition of oral steroids. TL can be symptomless presenting a paradoxical reaction during treatment. The uniqueness of our case lies in the patient’s advanced age, which is uncommon with cervical lymphadenopathy as a form of extrapulmonary tuberculosis, as well as in the administration of oral steroids to resolve the neck’s clinical deterioration. The patient had a complete recovery and was free of disease after completion of his six-month antituberculous chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Left Lateral Cervical Mass with Draining Sinuses

Michaelides

Bablekos

Michailidis

et al. 2019

Case Reports in Medicine

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“…The treatment group received category 1 ATT with 0.75 mg/kg prednisolone for four weeks but not more than 40 mg in total, tapered to 0.5 mg/kg for another four weeks and subsequently reduced by 5 mg every week to reach a zero dose. 12 The control group received only category 1 ATT.…”

Section: Methodsmentioning

confidence: 99%

“…10 Very few randomised controlled clinical trials have been conducted using additional steroids in lymph node TB. 11,12…”

Section: Introductionmentioning

confidence: 99%

Outcome of lymph node tuberculosis management with conventional treatment with and without prednisolone

Sharmin¹,

Hossain

Islam

et al. 2021

Trop Doct

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The outcome of lymph node tuberculosis (LNTB) management with conventional anti-tubercular treatment alone is unsatisfactory. We conducted a randomised open-label controlled clinical trial in the Department of Respiratory Medicine in Government Institute of Dhaka, Bangladesh from April 2017 to March 2019. Compared with controls, 54 patients of LNTB received category 1 anti-tubercular treatment with additional prednisolone after randomisation. Complete resolution in 21/54 (75%) and 7 (26.9%), symptomatic improvement in 26 (92.9%) and 22 (84.6%) and complications in 11 (39.28%) and 16 (61.53%) were observed in the treatment and control group, respectively. Thus, we recommend the use of steroids in this setting.

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“…Lymph node TB (LNTB) is one of the more common forms of extrapulmonary TB and constitutes about 20–40% of such cases. A clinical trial conducted in 2016 found that 57 out of 60 patients receiving a gradually tapered dosage of adjuvant prednisolone for 4 weeks had complete resolution of LNTB, compared to 44 out of 60 patients in the group that did not receive the corticosteroid [ 69 ]. A recent trial also recommended the use of adjuvant prednisolone in treating LNTB as researchers observed higher rates of complete resolution and symptomatic improvement, as well as lower rates of complications in the patients that received prednisolone [ 70 ].…”

Section: Adjuvantsmentioning

confidence: 99%

Review of the Effectiveness of Various Adjuvant Therapies in Treating Mycobacterium tuberculosis

Amin

Vartanian

Yegiazaryan

et al. 2021

Infectious Disease Reports

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Tuberculosis disease is caused by the bacterium Mycobacterium tuberculosis. It is estimated that 10 million people have developed tuberculosis disease globally, leading to 1.4 million deaths in 2019. Treatment of tuberculosis has been especially challenging due to the rise of multidrug-resistant (MDR-TB) and extensive drug-resistant (XDR-TB) tuberculosis. In addition to drug-resistant genotypes, the standard treatment of tuberculosis by first-line agents is also challenging due to toxicity and costs. In the last four decades, there have only been two new anti-tuberculosis agents—bedaquiline and delamanid. Therefore, shorter, safer, and more cost-effective therapies are needed to adequately treat tuberculosis. In this review, we explore various adjuvants such as glutathione, everolimus, vitamin D, steroid, aspirin, statin, and metformin and their usefulness in reducing the burden of tuberculosis. Glutathione, everolimus, aspirin, and metformin showed the most promise in alleviating the burden of tuberculosis. Despite their potential, more clinical trials are needed to unequivocally establish the effectiveness of these adjuvants as future clinical therapies. Methods: The journals for this review were selected by conducting a search via PubMed, Google Scholar, and The Lancet. Our first search included keywords such as “tuberculosis” and “adjuvant therapy.” From the search, we made a list of adjuvants associated with tuberculosis, and this helped guide us with our second online database search. Using the same three online databases, we searched “tuberculosis” and “respective therapy.” The adjuvants included in the paper were selected based on the availability of sufficient research and support between the therapy and tuberculosis. Adjuvants with minimal research support were excluded. There were no specific search criteria regarding the timing of publication, with our citations ranging between 1979 to 2021.

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Add-on prednisolone in the management of cervical lymph node tuberculosis

Cited by 7 publications

References 9 publications

Left Lateral Cervical Mass with Draining Sinuses

Left Lateral Cervical Mass with Draining Sinuses

Outcome of lymph node tuberculosis management with conventional treatment with and without prednisolone

Review of the Effectiveness of Various Adjuvant Therapies in Treating Mycobacterium tuberculosis

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