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Corticosteroids in primary tuberculosis with bronchial obstruction

M Toppet1, A Malfroot, M P Derde

  • 1Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles, Belgium.

Archives of Disease in Childhood
|November 1, 1990
PubMed

Insights

Adding prednisolone to standard antituberculous drugs significantly speeds recovery and reduces complications in children with primary lung tuberculosis and bronchial obstruction. However, steroid treatment requires reliable patient adherence to avoid potential harm.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Primary lung tuberculosis with hilar adenopathy can cause bronchial obstruction in children.
  • Standard antituberculous drugs are effective but may not fully alleviate obstructive symptoms.
  • The role of corticosteroids in managing pediatric tuberculosis complications requires further investigation.

Purpose of the Study:

  • To evaluate the efficacy and safety of adding prednisolone to standard antituberculous therapy in children with primary lung tuberculosis and bronchial obstruction.
  • To assess the impact of prednisolone on the rate of healing and complication development.

Main Methods:

  • A randomized controlled trial involving 29 children with primary lung tuberculosis and hilar adenopathy.
  • Two groups were formed: one received standard antituberculous drugs plus prednisolone, the other received standard drugs alone.
  • Patients were monitored via radiography and bronchoscopy for treatment response and complications.

Main Results:

  • Tuberculous infection healed in both groups.
  • The prednisolone group showed earlier improvement and significantly fewer radiographic and bronchoscopic complications.
  • Two patients on steroids had progressive lesions, linked to non-compliance or secondary infections.

Conclusions:

  • Prednisolone, when combined with potent antituberculous drugs, accelerates healing and reduces complications in pediatric primary lung tuberculosis with bronchial obstruction.
  • Treatment reliability is crucial; prednisolone is not recommended if adherence cannot be guaranteed due to potential risks outweighing benefits.

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