Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis

There remains uncertainty regarding the treatment strategy for patients with peripheral tuberculous lymphadenitis (pTBL) in areas endemic for tuberculosis. The purpose of this study was to demonstrate the clinical features and assess the predictors of a complicated treatment course in pTBL. Methods:...

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Main Authors: Yu-Feng Wei, Yuang-Shuang Liaw, Shih-Chi Ku, You-Lung Chang, Pan-Chyr Yang
Format: Article
Language:English
Published: Elsevier 2008-03-01
Series:Journal of the Formosan Medical Association
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664608601400
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author Yu-Feng Wei
Yuang-Shuang Liaw
Shih-Chi Ku
You-Lung Chang
Pan-Chyr Yang
author_facet Yu-Feng Wei
Yuang-Shuang Liaw
Shih-Chi Ku
You-Lung Chang
Pan-Chyr Yang
author_sort Yu-Feng Wei
collection DOAJ
description There remains uncertainty regarding the treatment strategy for patients with peripheral tuberculous lymphadenitis (pTBL) in areas endemic for tuberculosis. The purpose of this study was to demonstrate the clinical features and assess the predictors of a complicated treatment course in pTBL. Methods: A retrospective analysis of 97 pTBL patients from January 1995 through to December 2004 was conducted. Patient characteristics with and without a complicated treatment course, defined as prolonged treatment (> 9 months) and/or relapse, were compared for determining the predictors. Results: The disease occurred predominantly in females (57.7%) with a mean age of 37. Most patients (72%) were asymptomatic. Cervical nodes were the most common (72%) manifestations. Fifty-six patients completed a 6-9 month course of therapy without relapse; 28 had a prolonged but complete treatment course, and 13 relapsed within a mean of 8.5 months after treatment (range, 3-42 months; median, 7.8 months). Of 97 pTBL patients, six had enlarged or newly appeared lymph nodes during treatment. Multivariate analysis indicated that low body mass index and bilateral cervical nodes were independent determinants of a complicated treatment course with the odds ratios of 1.2 (95% CI, 1.01-1.41; p = 0.042) and 3.9 (95% CI, 1.08-14.0; p = 0.038), respectively. Conclusion: This study found that pTBL is more likely to occur in young female patients. For patients who present with bilateral cervical nodes and low body mass index, a prolonged treatment course to ensure disease control should be considered.
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spelling doaj.art-cad39860d0fe4421b9bf33accc9003b12022-12-21T17:16:19ZengElsevierJournal of the Formosan Medical Association0929-66462008-03-01107322523110.1016/S0929-6646(08)60140-0Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous LymphadenitisYu-Feng Wei0Yuang-Shuang Liaw1Shih-Chi Ku2You-Lung Chang3Pan-Chyr Yang4Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanThere remains uncertainty regarding the treatment strategy for patients with peripheral tuberculous lymphadenitis (pTBL) in areas endemic for tuberculosis. The purpose of this study was to demonstrate the clinical features and assess the predictors of a complicated treatment course in pTBL. Methods: A retrospective analysis of 97 pTBL patients from January 1995 through to December 2004 was conducted. Patient characteristics with and without a complicated treatment course, defined as prolonged treatment (> 9 months) and/or relapse, were compared for determining the predictors. Results: The disease occurred predominantly in females (57.7%) with a mean age of 37. Most patients (72%) were asymptomatic. Cervical nodes were the most common (72%) manifestations. Fifty-six patients completed a 6-9 month course of therapy without relapse; 28 had a prolonged but complete treatment course, and 13 relapsed within a mean of 8.5 months after treatment (range, 3-42 months; median, 7.8 months). Of 97 pTBL patients, six had enlarged or newly appeared lymph nodes during treatment. Multivariate analysis indicated that low body mass index and bilateral cervical nodes were independent determinants of a complicated treatment course with the odds ratios of 1.2 (95% CI, 1.01-1.41; p = 0.042) and 3.9 (95% CI, 1.08-14.0; p = 0.038), respectively. Conclusion: This study found that pTBL is more likely to occur in young female patients. For patients who present with bilateral cervical nodes and low body mass index, a prolonged treatment course to ensure disease control should be considered.http://www.sciencedirect.com/science/article/pii/S0929664608601400clinical featurespredictorstreatment coursetuberculous lymphadenitis
spellingShingle Yu-Feng Wei
Yuang-Shuang Liaw
Shih-Chi Ku
You-Lung Chang
Pan-Chyr Yang
Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
Journal of the Formosan Medical Association
clinical features
predictors
treatment course
tuberculous lymphadenitis
title Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
title_full Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
title_fullStr Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
title_full_unstemmed Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
title_short Clinical Features and Predictors of a Complicated Treatment Course in Peripheral Tuberculous Lymphadenitis
title_sort clinical features and predictors of a complicated treatment course in peripheral tuberculous lymphadenitis
topic clinical features
predictors
treatment course
tuberculous lymphadenitis
url http://www.sciencedirect.com/science/article/pii/S0929664608601400
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