Comparison of resolution of Tuberculous pleural effusion on Anti – tubercular treatment with and without steroids : A one-year follow–up

<b>Introduction:</b> Pleural effusion occurs in up to 30% of cases of tuberculosis. It typically involves young age groups. It is an immunological reaction to mycobacterial antigens. It presents with chest pain, breathlessness and, constitutional symptoms like fever, cough, loss of appetite, weight. Antituberculosis treatment (ATT) is the treatment of choice associated with complete resolution in most cases. However, pleural thickening may develop in some patients (pts) [1]. Adjunctive use of corticosteroids is believed to hasten recovery and reduce the incidence of pleural thickening. <b>Aims:</b> 1. To evaluate the clinical effect of ATT and steroid for TB pleural effusion in terms of cough, chest pain, dyspnea, fever. 2. To study radiological improvement post steroid treatment <b>Methodology:</b> 40 patients of TB pleural effusion were divided into two groups: one received ATT regimen and other group received oral prednisolone 0.75mg/kg in addition to ATT for 4 wks. Steroids were tapered down gradually over 2weeks. Chest Xrays were performed in both groups fortnightly up to 2 months and at 6 months of treatment. <b>Result:</b> The incidence of radiographic sequelae or clinical symptoms was significantly decreased in the prednisolone group as compared to control group. <b>Conclusions:</b> We found that adjunctive prednisolone therapy was associated with decreased incidence of radiographic and functional sequelae in free-flowing type TPE patients. Resolution of clinical symptoms and effusion were significantly higher in steroid group as compared to control group.