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November 1965

Primary Tuberculosis in Childhood: Indications and Contraindications for Corticosteroid Therapy: Observations on 577 Treated Cases

Author Affiliations

From Service de Pneumo-Phtisiologie infantile, Hôpital Leon Bernard.

Am J Dis Child. 1965;110(5):507-518. doi:10.1001/archpedi.1965.02090030531004

THE ADVERSE effect of corticosteroids has been demonstrated experimentally in tuberculous animals.7,20,28,30,44 However, the dosage in these experiments was high, about ten times the amount currently used in human beings. Other experiments, in which there was a smaller dose of steroids associated with specific antituberculosis drugs have demonstrated the favorable effect of hormonotherapy on exudative lesions in laboratory animals.2,4,33 In tuberculous lymph nodes, steroids reduce both necrosis and the formation of epithelioid cells and exert an inhibitory effect on fibrosis.24

In clinical medicine, the deleterious effect of steroid treatment on tuberculous lesions has also been observed,4,10 but here also the combination of steroid treatment with effective antituberculosis chemotherapy gives excellent results in certain selected cases.1,5,9 It was first claimed to be effective in pleural effusions40 and the claim then extended to some other forms of human tuberculosis.3 Favorable effects were confirmed by pathologic

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