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Suggest Treatment For Tuberculous Lymphadenitis
Question: Hi Doctor,
My wife (28 yrs old), is there in her 21st week of pregnancy . She had a lump on the side of her neck and it was removed within a week, the biopsy report on the same confirmed that it was a Tuberculous lymphadenitis. We consulted a pulmunalogist for the same and it was recommended that she have to start AKT4 within a week(after confirming with her Gynecologist) , the specialist even confirmed that it he cannot give 100% chances that there will be no abnormalities in the baby. But myself and my wife are very much scared of the very thought that something could happen to the baby. Can you please advice on what should be done further. Also will it be required to termintae the pregnancy now??
Please Help
My wife (28 yrs old), is there in her 21st week of pregnancy . She had a lump on the side of her neck and it was removed within a week, the biopsy report on the same confirmed that it was a Tuberculous lymphadenitis. We consulted a pulmunalogist for the same and it was recommended that she have to start AKT4 within a week(after confirming with her Gynecologist) , the specialist even confirmed that it he cannot give 100% chances that there will be no abnormalities in the baby. But myself and my wife are very much scared of the very thought that something could happen to the baby. Can you please advice on what should be done further. Also will it be required to termintae the pregnancy now??
Please Help
Brief Answer:
Abortion is not needed.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
AKT4 contains- Rifampicin: 450 mg, Isoniazid: 300 mg, Pyrizinamide: 750 mg, Ethambutol: 800 mg
In pregnancy, these drugs come under category C means animal studies shown teratogenic effects - defects in the animal babies but human studies are lacking.
Rifampicin: can be used when benefits over weigh the risks.
Isoniazid: neonates should be given vitamin K after birth to prevent postpartum hemorrhage.
Pyrizinamide: may cause neural tube defects, hearing loss in new born.
Ethambutol: chances of ophthalmic abnormalities in newborn.
All these abnormalities are more common if the medicines are taken before 20 weeks of pregnancy. By 20 weeks, the organogenesis is complete and the chances of any neural tube defects or eye abnormalities are very much reduced.
Since your wife is having an active infection., she should start taking the medicines as prescribed. The chances of any defect are less than 3%. There is no need to abort the baby as she has already completed her 20 weeks of pregnancy. After starting the medicines you need to have an ultrasound scan of the baby at regular intervals to see any defects or the baby's progress.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Abortion is not needed.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
AKT4 contains- Rifampicin: 450 mg, Isoniazid: 300 mg, Pyrizinamide: 750 mg, Ethambutol: 800 mg
In pregnancy, these drugs come under category C means animal studies shown teratogenic effects - defects in the animal babies but human studies are lacking.
Rifampicin: can be used when benefits over weigh the risks.
Isoniazid: neonates should be given vitamin K after birth to prevent postpartum hemorrhage.
Pyrizinamide: may cause neural tube defects, hearing loss in new born.
Ethambutol: chances of ophthalmic abnormalities in newborn.
All these abnormalities are more common if the medicines are taken before 20 weeks of pregnancy. By 20 weeks, the organogenesis is complete and the chances of any neural tube defects or eye abnormalities are very much reduced.
Since your wife is having an active infection., she should start taking the medicines as prescribed. The chances of any defect are less than 3%. There is no need to abort the baby as she has already completed her 20 weeks of pregnancy. After starting the medicines you need to have an ultrasound scan of the baby at regular intervals to see any defects or the baby's progress.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks for the reply.
I have few more questions to ask,which I've listed below. Please answer them ,it would be of great help..
1. Are there any side effects for my wife , during medication or post medication. I had read that there is some liver damage that happen due to AKT4 , please clarify on how much will be the severity of the damage.?
2. She had the lump 4 weeks before and the surgery was performed 2 weeks proir to today's date . Are there any chances ,that we would have missed the intial symptoms or is that lump the only symptom for this ?
3. She is also taking supplement tablets namely Calwatt and Bravofer ,can she continue these 2 supplements along with AKT4?
4. We are not sure on how this originated ,what could be causes for the same .?
5. Post pregnancy , is there any vaccination that will be required for the baby ,so that no abnormalities happens to the baby.
Other than these, is there anything at all (food , excercise, supplements etc..) to keep both my wife and baby without any problem ,during pregnancy and post pregnancy ?
Awaiting your response.
Thanks for the reply.
I have few more questions to ask,which I've listed below. Please answer them ,it would be of great help..
1. Are there any side effects for my wife , during medication or post medication. I had read that there is some liver damage that happen due to AKT4 , please clarify on how much will be the severity of the damage.?
2. She had the lump 4 weeks before and the surgery was performed 2 weeks proir to today's date . Are there any chances ,that we would have missed the intial symptoms or is that lump the only symptom for this ?
3. She is also taking supplement tablets namely Calwatt and Bravofer ,can she continue these 2 supplements along with AKT4?
4. We are not sure on how this originated ,what could be causes for the same .?
5. Post pregnancy , is there any vaccination that will be required for the baby ,so that no abnormalities happens to the baby.
Other than these, is there anything at all (food , excercise, supplements etc..) to keep both my wife and baby without any problem ,during pregnancy and post pregnancy ?
Awaiting your response.
Brief Answer:
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
1. every medicine has side effects. These drugs cause liver damage that is mild. There can be itching nausea loss of appetite and headache. This will all improve as she finishes with her medicines. She can be given a liver protective medicine like Liv. 52 to decrease the effect on liver.
2. The lump can be associated with fever, loss of appetite, etc.
3. Yes. She can continue with these supplements.
4. This can happen through the environment or someone infected in the neighborhood.
5. Vaccinations cannot prevent the abnormalities. Only an injection of Vitamin K will be sufficient. The baby will also be given Inj. BCG after birth.
She needs to take her care with high protein diet and a calcium rich food. A multivitamin supplement will also be added after she starts with these medicines.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Details below.
Detailed Answer:
Hello.
Thanks for writing again.
1. every medicine has side effects. These drugs cause liver damage that is mild. There can be itching nausea loss of appetite and headache. This will all improve as she finishes with her medicines. She can be given a liver protective medicine like Liv. 52 to decrease the effect on liver.
2. The lump can be associated with fever, loss of appetite, etc.
3. Yes. She can continue with these supplements.
4. This can happen through the environment or someone infected in the neighborhood.
5. Vaccinations cannot prevent the abnormalities. Only an injection of Vitamin K will be sufficient. The baby will also be given Inj. BCG after birth.
She needs to take her care with high protein diet and a calcium rich food. A multivitamin supplement will also be added after she starts with these medicines.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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