Treatment of Pulmonary Tuberculosis with ACTH and Cortisone in Addition to Specific Anti-Tuberculosis Therapy

¹ Malben Hospital for Chest Diseases.

Twenty-nine cases of pulmonary tuberculosis, of whom 14 were recent, nine were chronic with exacerbation and six were chronic without exacerbation received hormonal treatment, in combination with antimicrobial drugs, during a period varying from two to three months. This treatment was also administered to persons who had pleural fluid asthma, and its complicating tuberculosis.

Cortisone and ACTH can be used safely under antibiotic coverage for the treatment of exudative fresh lesions in pulmonary tuberculosis. Exudative lesions with or without cavitation showed marked improvement compared to treatment without the addition of cortisone-time interval being the same. Identical results pertain to sputum conversion.

Exudative pleurisy and tuberculosis peritonitis improved markedly in a shorter time interval than usual. Chronic pulmonary tuberculosis did not show appreciable x-ray film changes.

In rare cases of respiratory failure and heart failure secondary to con pulmonale, that did not respond to accepted medical treatment, the addition of cortisone improved the hopeless state.

In cases where antibiotic treatment was not tolerated, addition of cortisone made treatment possible.

The average period of cortisone and ACTH administration in pulmonary tuberculosis was two months. In cases of tuberculous exudative pleurisy treatment was limited to one month. The side effects noted were those of mild and transient glycosuria in isolated cases, mild osteoporosis in one case, and a relative transient elevation of blood pressure in a young man at the termination of treatment. No complication was noted that made interruption of treatment imperative.