Role of steroids in tuberculous pleural effusion

ABSTRACT

A comparative study was carried out from January 1992 to June 1994 on 60 confirmed cases of tuberculous pleural effusion to evaluate the adjuvant efficacy of gluco-corticosteroids [prednisolone 0.75 mg/Kg body weight daily] for first eight weeks along with first line anti-tuberculous therapy. Thirty patients were selected for steriod therapy regardless of age, sex [except pregnant females], duration of onset, socioeconomic status, severity of the effusion, and pulmonary involvement, while thirty acted as control. The average time for resolution of symptoms was one week in the steroid group as compared to three weeks in the non-steroid group. The average time for resorption of effusion clinically was three weeks in the steroid group, but four weeks in the non-steroid group. However, on radiology the average time for resorption of effusion was four and seven weeks in the steroid and non-steroid groups respectively. Residual pleural thickening was 10% in the steroid group and 40% in the non-steroid group. Furthermore, patients in the steroid group demonstrated a much faster gain in weight and haemoglobin concentration together with a quicker reduction of the ESR. The results of the current study clearly indicate that glucocorticoids [prednisolone] when used as an adjuvant to anti-tuberculous therapy cause early improvement of general health and pleural effusion resorption besides decreasing pleural thickening and pulmonary disabilities without flaring up the disease