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LETTER TO EDITOR
Year : 2010  |  Volume : 2  |  Issue : 1  |  Page : 49 Table of Contents   

Steroids: A promising drug for abdominal tuberculosis?


Immunodeficiencies Unit, Hospital 12 Octubre, Carretera Andalucia km 5,400, Madrid, Spain

Date of Web Publication23-Jul-2010

Correspondence Address:
Luis Ignacio Gonzalez-Granado
Immunodeficiencies Unit, Hospital 12 Octubre, Carretera Andalucia km 5,400, Madrid
Spain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2727.66702

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How to cite this article:
Gonzalez-Granado LI. Steroids: A promising drug for abdominal tuberculosis?. J Lab Physicians 2010;2:49

How to cite this URL:
Gonzalez-Granado LI. Steroids: A promising drug for abdominal tuberculosis?. J Lab Physicians [serial online] 2010 [cited 2019 Aug 22];2:49. Available from: http://www.jlponline.org/text.asp?2010/2/1/49/66702

Sir,

I am grateful for the excellent contribution of Dasgupta A et al.[1] to the study of abdominal tuberculosis, but I would like to make one comment. The authors show that vasculitis is a major mechanism of disease in abdominal involvement of tuberculosis. It has been previously demonstrated that steroids added to the general anti-tuberculous regimen could decrease mortality in these patients. [2],[3] In pericardial and meningeal involvement, steroids have demonstrated a better outcome, since vasculitis represents a pathogenic contribution to the injury caused by Mycobacterium tuberculosis. Adjunctive prednisolone in the treatment of effusive tuberculous pericarditis has proven efficacy in HIV patients with a reduction of death risk (relative risk 0.5) [2] Treatment with dexamethasone was associated with a reduced risk of death in tuberculous meningitis (relative risk, 0.69) although it was not associated with a significant reduction in the proportion of severe sequelae. [3]

These preliminary evidence should encourage starting randomized controlled trials to definitely support the use of steroids in abdominal tuberculosis. This novel approach could even help to decrease the need of surgery as perforation and bowel obstruction could be avoided.

 
   References Top

1.Dasgupta A, Singh N, Bhatia A. Abdominal tuberculosis: A histopathological study with special reference to intestinal perforation and mesenteric vasculopathy. J Lab Physicians 2009;1:56-61.  Back to cited text no. 1    Medknow Journal  
2.Hakim JG, Ternouth I, Mushangi E, Siziya S, Robertson V, Malin A. Double blind randomised placebo controlled trial of adjunctive prednisolone in the treatment of effusive tuberculous pericarditis in HIV seropositive patients. Heart 2000;84:183-8.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Thwaites GE, Nguyen DB, Nguyen HD, Hoang TQ, Do TT, Nguyen TC, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med 2004;351:1741-51.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  




 

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