Title: Efficacy of Four drug regimen vs. Three drug regimen in Patients of Tuberculous Lymphadenitis, Registered at S.N Medical College, Agra
Authors: Dr Rajendra Saini, Dr Santosh Kumar, Dr Rajesh Kumar Gupta, Dr S.K Kaushal, Dr Benhur Joel Shadrach, Dr Urvashi Verma, Dr Harendra Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.32
Abstract
Background: Tuberculosis can involve any system in the body. About 15% of people may develop tuberculosis in any organ other than lung. Lymph nodes are most common extra pulmonary site of get involved. Disease may affect a single lymph node or a number of lymph nodes in a particular chain sometimes bilaterally
Aims: To compare the efficacy of 4 drug Regimen (HRZE) vs.3 drug Regimen (HRE) in patients of tuberculous lymphadenitis
Materials and Methods: Patients of proved cases of tuberculous lymphadenitis by FNAC (Fine Needle Aspiration Cytology) have been selected for this study, irrespective of age, sex, case and religion. No discrimination has been made regarding site size or number of lymph nodes. These patients are those who attended OPD of the department of Tuberculous and Chest Diseases. The results of both regimens were compared in relation to decrease in the size of lymph node(s) clinical, hematological and other investigation relevant in the diagnosis.
Result: In HRZE group (56) lymph nodes were completely resolved in 42 (75%) cases. Residual lymph nodes (>2 cm) were present in 14 (25%) which on further FNAC 8(14.3%) were positive. Favorable response were seen in 48 (85.7%) cases. 7 (12.5%) cases were treated on retreatment. One case 1 (1.7%) was resistant to rifampicin and isoniazid which was treated with multi drug resistant treatment. In HRZ group (50) lymph nodes were completely resolved in 32 (64%) cases. Residual lymph nodes (> 2 cm) were present in 18 (36%) cases. Further FNAC was positive in 12 (24%) cases. Thus favorable response were seen in 38 (76%) cases. 10 (20%) cases responded on retreatment while 2 (4%) cases presented with drug resistant.
Conclusion: The study shows that 6 months, thrice weekly HRZ regimen in initial intensive phase for tuberculous lymphadenitis showed response rate 76% while HRZE regimen in initial intensive phase showed 85.7% response rate. So HRZE seem to have more efficacy than HRZ in treatment of tuberculous lymphadenitis.
Keywords: Tubercular Lymphadenitis, HRZE, HRZ, FNAC.
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