The Place of Steroids in Pulmonary Disease

¹ Philadelphia General Hospital, Northern Division, and Rush Hospital.

This presentation attempted to determine the place of steroids in pulmonary diseases, especially tuberculosis. The beneficial effects of various steroids in rheumatoid arthritis, asthma, collagen diseases, etc., are well known. However, we reported 38 patients, who had reactivation of latent or inactive tuberculosis following such therapy. The physician must investigate the presence of tuberculosis, by skin test and x-ray films, and when in doubt, simultaneously administer anti-tuberculosis drugs. Only by using these drugs judiciously, that is, the minimum dosage for the shortest period necessary to obtain the desired effects, are complications diminished.

Paradoxically, the value of steroids in the treatment of tuberculosis has been established. From its life-saving action in 33 acute, toxic, miliary, meningeal, etc., to its stimulation effect in 60 chronic patients, either prolonging their lives, or hastening desensitization thus allowing more effective therapy. All of these patients received effective anti-tuberculosis chemotherapy during this study.