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August 15, 1959


Author Affiliations


From Philadelphia General Hospital, Northern Division, Rush Hospital, Germantown Hospital, and Wolffe Hospital.

JAMA. 1959;170(16):1885-1890. doi:10.1001/jama.1959.03010160001001

The effect of steroid therapy was investigated in 36 patients with acute and 107 patients with chronic forms of tuberculosis. The steroid used, prednisolone, was added to the regular regimen of streptomycin, isoniazid, and para-aminosalicylic acid. It was started at 50 mg. in divided doses for the 1st day and gradually reduced to 15 mg. by the 23rd day. Two case histories illustrate the recoveries seen in patients with the acute tuberculosis; there frequently was rapid objective improvement, and 32 patients recovered, including 8 with tuberculous meningitis. Two further case histories illustrate the striking results in chronic tuberculosis. The group of 107 included 20 patients who had been expected to die, and 15 of these recovered. The beneficial use of corticosteroids in the treatment of many diseases is well accepted, but the fact that it can reactivate tuberculosis is ofttimes overlooked. A typical case history illustrates such reactivation during treatment of lupus erythematosus with corticosteroids.