Yu Y, Luo Y, Huang HJ. Our experience with glucocorticoid treatment of tuberculous peritonitis.
Shijie Huaren Xiaohua Zazhi 2015;
23:1679-1682. [DOI:
10.11569/wcjd.v23.i10.1679]
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Abstract
AIM: To investigate the indications and methods for the application of glucocorticoid treatment in exudative tuberculous peritonitis (TBP) in order to achieve the best treatment effect.
METHODS: Thirty patients with exudative TBP hospitalized in the same period were chosen as subjects and given glucocorticoid 2 wk after anti-tuberculosis treatment. According to the result of glucocorticoid treatment, the patients were divided into either group A (excellent and effective; n = 18) or group B (invalid or deteriorated; n = 12). The basic conditions, clinical manifestations, complications, auxiliary examination, treatment effect and prognosis were compared for the two groups.
RESULTS: Patients in groups A and B had different average age (29.1 years ± 29.1 years vs 48.5 years ± 20.8 years, P < 0.05). Complications in groups A and B were as follows: adhesive type TBP (2/18 vs 9/12), intestinal tuberculosis (1/18 vs 2/12), tuberculous pleurisy (12/18 vs 2/12), and ovarian tuberculosis (1/18 vs 2/12) (P < 0.05 for all). In group A, 12 cases had high fever, and 5 cases had moderate fever; in group B, 5 cases had moderate fever, and 7 cases had low grade fever. PPD test was strongly positive in 10 cases and positive in 8 cases in group A, and positive in 5 cases and weakly positive in 7 cases in group B. In group A, ESR was greater than 100 mm/h in 10 cases, 50-100 mm/h in 4 cases, and 20-50 mm/h in 1 case; in group B, ESR was 50-60 mm/h in 2 cases and 20-50 mm/h in 10 cases. In group A, 8 cases had massive ascites, and 10 cases had moderate ascites; in group B, 3 cases had moderate ascites, and 9 cases had mild ascites. In group A, 14 cases had an excellent response, their urine volume increased 300-500 mL/d, and abdominal distention was greatly relieved; 4 cases had effective results, their urine volume increased 200-350 mL/d, and distension was alleviated. Only a small amount of ascites was detected by ultrasound after four weeks of glucocorticoid treatment and ascites disappeared after 6-8 wk. In contrast, no significant improvement was observed in all the 12 cases of group B. Ascites was not reduced and distension was not improved after the glucocorticoid treatment. Ascites disappeared after 5-8 wk. In a follow-up period of 6 mo, all patients had neither disease progression nor related complications and recovered well.
CONCLUSION: Glucocorticoid is mainly suitable for exudative TBP patients who had strong allergic reaction. After 2 wk of regular anti-tuberculosis treatment, the application of glucocorticoid following the principle of short period, small quantity, draught, and decrement is safe and effective.
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