Resolution of residual pleural disease according to time course in tuberculous pleurisy during and after the termination of antituberculosis medication.
OBJECTIVE
To assess the resolution of pleural disease in patients with tuberculous pleurisy (TP) during and after antituberculosis medication.


METHODS
An observational, prospective, longitudinal study.


METHODS
University-affiliated general hospital in Seoul, Korea.


METHODS
Chest radiographs of 85 adult TP patients were followed up prospectively from diagnosis to 24 months after the start of medication. The extent of pleural disease, synonymous with the radiographic term, pleural opacity (PO), was evaluated at regular intervals according to a size scale. Additionally, following completion of 6 months of therapy, residual PO (RPO) was determined by either measurement of the widest width of the opacity, if loculated, or at the superior level of the hemidiaphragm.


RESULTS
Seventy-seven patients had a PO graded > or = 2 at the initial presentation. At 6, 9, and 24 months, the number of patients with these grades declined. At these time periods, there were 14, 8, and 7 patients, respectively, remaining with this classification. RPO > 10 mm at 24 months was considered indicative of significant residual pleural disease. During the period after 6 months of antituberculosis medication, the number of patients with RPO > or = 10 mm declined from 43 patients at 6 months to 21 patients at 24 months. The presence of loculation on an initial chest decubitus view was associated with significant RPO at 24 months (p = 0.009).


CONCLUSIONS
In TP patients, improvement of RPO often occurred even after completion of 6 months of antituberculosis medication up to 24 months. A loculated PO at initial presentation, but not initial PO size, was a predictor of significant RPO at 24 months.
Han
Dae-Hee
DH
Departments of Radiology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Korea.
Song
Jae-Woo
JW
Chung
Hee-Soon
HS
Lee
Jae-Ho
JH
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D045022:Lactate Dehydrogenases / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010996:Pleural Effusion / Q000737:chemistry; D011446:Prospective Studies; D013997:Time Factors; D014396:Tuberculosis, Pleural / Q000150:complications / Q000188:drug therapy*
D000995:Antitubercular Agents; D045022:Lactate Dehydrogenases