Experience of using early surgical treatment and the immunomodulator betaleukin in the comprehensive therapy of tuberculosis of peripheral lymph nodes

BACKGROUND: Tuberculosis of peripheral lymph nodes remains a pressing problem of extrapulmonary tuberculosis in the Republic of Kazakhstan, ranking second in the morbidity structure. The search for ways to optimize treatment, including the timing of surgical intervention and the use of pathogenetic therapy, is an important task of clinical phthisiology. AIM: To evaluate the efficacy of comprehensive treatment of patients with tuberculosis of peripheral lymph nodes, including early lymphadenectomy and the use of the immunomodulator betaleukin, compared with the standard approach of delayed surgical treatment. METHODS: We retrospectively analyzed treatment outcomes of 69 patients with tuberculosis of peripheral lymph nodes. The main group (n = 35) consisted of patients treated in 2023–2024 who received comprehensive treatment: standard chemotherapy, early lymphadenectomy (within 1–1.5 months from the start of chemotherapy), and the immunomodulator betaleukin. The comparison group (n = 34) consisted of patients treated in 2018–2019 who received standard chemotherapy with delayed surgical treatment (at 4–4.5 months) without immunomodulators. RESULTS: In the main group, relief of intoxication symptoms was significantly more frequent in the first 3 months (85.7% vs 61.7% in the comparison group, p 0.05) and disappearance of periadenitis was faster (80% vs 44.1%, p 0.05). In patients with fistulas in the main group, closure occurred earlier: by 2 months after curettage, fistulas had closed in 61.5% of patients, while in the comparison group, closure took longer (only 33.3% of patients had fistula closure by 3 months). CONCLUSION: The use of the developed approach, which includes early surgical intervention and immunomodulation with betaleukin, made it possible to accelerate the regression of local manifestations of the disease and shorten the duration of treatment for patients with tuberculosis of peripheral lymph nodes. Further studies are required to clarify the contribution of each component of treatment.