Predicting deterioration of treated tuberculosis by corticosteroid reserve and C-reactive protein

Eighteen patients with recently diagnosed pulmonary tuberculosis were studied for factors which could predict, at the outset, reactions to treatment. Abnormally low corticosteroid responses to tetracosactrin were seen in some but not all of the patients who deteriorated while on treatment. Those who deteriorated transiently or died had pre-treatment C-reactive protein (CRP) concentrations above 20 mg/l, which then persisted. As previously observed, those who responded unfavourably were older, had extensive disease and presented with hypoalbuminaemia and hyponatraemia.