Pengaruh Jintan Hitam (Nigella Sativa) pada Konversi Sputum dan IFN- γ Penderita Tuberkulosis Paru yang Mendapat OAT Kategori I pada Akhir Minggu Kedua Fase Intensif

Ahmad Nurdin, Helmia Hasan

Abstract views = 441 times | downloads = 741 times


Background: Primary resistance is the resistance that occurs in patients who have never received treatment OAT or had ever received  treatment OAT is less than 1 month. The incidence of primary MDR in Central Java in 2006 2.07%. Extrapulmonary TB about 15-20%  of all cases of TB, and TB lymphadenitis is the highest form (35% of all extrapulmonary TB). Patients with decreased immune systems  (SLE) can increase the incidence of TB. Research in Spain get 6x higher TB incidence in patients with SLE. Case: We present the case  of 19 year old woman SLE who received treatment for 11 months whose came with shortness of breath and chronic cough since 2 month  prior to admission. In physical examination we found right and left submandibula lymphonodi enlargement as solid, slightly mobile  nodule with diameter 3 cm. Chest X ray showed lung inflammation which suspicion of specific process and minimal left pleural effusion,  and concluded as pulmonary TB. FNAB confirmed lymphadenitis TB with granulomatous inflammation. One of AFB result is positive  and Gene Xpert is M.tb positive with rifampicin resistant that make this patient categorized as primary MDR TB with lymphadenitis  TB. This patient received Pirazinamid 1500 mg, Ethambutol 800 mg, Kanamicin 750 mg, Levofloxacin 750 mg, Ethionamide 500 mg,  Cicloserin 500 mg, and B6 100 mg. Conclusion: MDR TB in general occur in patients with a history of OAT previous TB (MDR TB  secondary). Primary MDR TB with lymphadenitis tb is a rare case, but can occur on the condition that decreases the immune system,  one of SLE. This involves multiple immune disorders caused by the use of long-term immunosuppressive therapy.  


Primary resistance, Lymphadenitis TB, SLE

Full Text:



World Health Organization. Global Tuberculosis Report 2012. Genewa, Swiss.

Perhimpunan Dokter Paru Indonesia. Tuberkulosis. Dalam: Tuberkulosis, Pedoman diagnosis dan penatalaksanaan di Indonesia. Balai Penerbit FKUI. Jakarta. 2011; h. 1-64.

Pajankar S, Khandekar R, Al Amri M, Al Lawati MR, Factor influencing sputum smear conversion of one and two month of Tuberculosis treatment. Oman Medical Journal 2008: Vol. 23.

Soedarsono. Evaluasi terapi tuberkulosis: klinis dan program. Dalam TB Update-II. Simposium Nasional, Lab/SMF Ilmu Penyakit Paru FK Unair/RSUD Dr. Soetomo Surabaya, 2003. 49-68.

Mitchison DA. Infectivity of patients with pulmonary tuberculosis during chemotherapy. Eur Respir J. 1990; 3: 385-6.

Wang JY, Lee LN, Yu CJ, Chien YJ, Yang PC, Tami Group. Factors influencing time to smears conversion in patients with smear positive pulmonary tuberculosis. Respirol. 2009;14:1012-9.

Chrisdiono H. Konversi sputum BTA pada penderita TB Paru kasus baru yang mendapat terapi OAT kategori 1 dan Phyllantus Niruri L. Penelitian karya akhir Bagian Paru UNAIR. 2003.

Bhatt K, Salgem P. Host innate immune response to Mycobacterium tuberculosis. J Clin Immunol. 2007; 27 (4): 347-62.

Reddy YN, Muthy SV. Role of free radicals and antioxidants in tuberculosis patients. Indian J Tuberc. 2004; 51: 213-18.

Mohod K, Dhok A, Kumar S. status of oxidants and antioxidants in pulmonary tuberculosis with varying bacillary load. Journal of Experimental Sciences 2011; 2 (6): 35-7.

Djauzi S. Perkembangan obat imunomodulator. Med J Ked 2003; 4 (2): 13-5.

Salem M. L. Immunomodulatory and Therapeutic Properties of The Nigella sativa L. Seed. International Immunopharmacology 2005; 5: 1749-70.

ElKadi A, Kandil O. Effect of Nigella sativa (the black seed) on immunity. Proceeding of 4th International Conference on Islamic Medicine, Kuwait. Bull Islamic Med 1986; 4: 344-8.

Mansour MA, Ginwai OT, El-Hadiya T, ElKhatib AS. Effects of volantile oil constituents of Nigella sativa on carbon tetrachlorida- induced Hepatotoxicity in mice: evidence for antioxidant effect of thymoquinone. Res Commun Mol Pathol Pharmacol. 2001; 110: 239-51.

Swamy SM, Tan BK. Cytotoxic and imunopotentiating effects of ethanolic extract of Nigella sativa L Seeds. J Ethnopharmacol 2000; 70: 1-7.

Randhawa MA. In Vitro Antituberculous activity of thymoquinone, An active principle of Nigella sativa. Journal Ayub Med Coll Abbottabad 2011; 23 (2):78-1.

Haq A, Abdullatif M, Lobo PI, Khabar KS, Sheth KV, Al-Sedairy ST. Nigella sativa : Effect on Human Lymphocytes and Polymorphonuclear Leucocyte Phagocytic Activity. Immunopharmacology 1995; 30 (2): 147-155.

Pedoman Diagnosis dan Terapi Bagian/SMF Ilmu Penyakit Paru RSU Dr. Soetomo Surabaya, 2005.

Departemen Kesehatan Republik Indonesia (2008), Pedoman Penanggulangan Tuberkulosis, edisi ke-2, Editor Aditama TY dkk, Balai Pustaka, Jakarta, hal. 3-4.

Schlossberg D. Tuberculosis and Non tuberculosis Mycobacterium Infection, 5nd ed. McGraw-Hill company, Philadelphia 2006, p.94- 103.

Baratawidjaya KG. Imunologi Dasar. edisi 7, Penerbit FKUI, Jakarta. 2006; hal. 411-7.

Abbas AK, Litchtman AH, Puber JS. Immunity to microbes. In: cellular and molecular immunology, 2nd ed. WE Saunders Company Philadelphia. 1994: p. 320-33.

Parslow TG, Bainton DF. Innate immunity. In: Parslow TG, Stites DP, Terr AL, Imboden JB, (Eds). Medical Immunology, 10th ed. New York The McGraw-Hill Companies 2001; 19-40.

Iseman MD. Immunity and pathogenesis. In: Iseman MD, A clinician’s Guide to Tuberculosis. Lippincott Williams and Wilkins. Philadelphia. 2000: p. 63-96.

Mattheas L, Steinmuller C, Ulliman GF. Pulmonary macrophage. Eur Respir J. 1994; 7: 1683-4.

Hashmi MA, Ahsan B, Shah SI. Antioxidant capacity and lipid peroxidation product in pulmonary tuberculosis. Al Ameen J Med Sci. 2012; 5 (3): 313-19.

Cohen K, Nyska A. Oxidation of biological system : Oxidative stress phenomena. Antioxidants, redox reaction and methods for their quantifications. Toxicologic part. 2002; 30 (6): 620-50.

Warren JR, Bhattacharya M, De Almeida KN, Trakas K, Peterson LR. A minimum 5.0 ml of sputum improves the sensitivity of acid fast smears for Mycobacterium tuberculosis. Am J Respir Crit Care Med. 2000 May; 161 (5): 1559-62.

Parikh R, Nataraj G, Kanade S, Khatri V, Mehta P. Time to sputum conversion in smear positive pulmonary TB patients on category I DOTS and factors delaying it. Journal Association of Physicians India. 2012: 60: 22-6.

A. van Deun. What is the role of mycobacterial culture in diagnosis and case definition? Toman’s Tuberculosis. Case detection, treatment, and monitoring-question Second edition. WHO, 2004; p 122-3.

Barnes PF, Wizel B. Type 1 cytokines and the pathogenesis of tuberculosis. A, J Respir Crit care Med. 2000; 161: 1773-4.

Dannenberg AM, Rook GAW. Pathogenesis of pulmonary tuberculosis: Interplay of tissue-and answers. Second edition. World Health Organization. Geneva. 2004.

Toman, K. What is the purpose of the initial intensive phase of two- phase treatment In: Toman’s Tuberculosis case detection, treatment and monitoring question and aswers. Eddamaging and macrophage- activating immune response, dual mechanism that control bacillary multiplication. In : Bloom BR, editor. ASM Press. Washington. 1994: p. 459-84.

Widjaja JT, Jasaputra DK. Analisis kadar interferon gamma pada penderita tuberkulosis paru dan orang sehat. J Respir Indo. 2010; 30 (2): 119-24.

Gilani A, Jabeen Q, Khan M. A Review of medicinal uses and pharmacological Activities of Nigella sativa . Pakistan Journal of Biological Sciences 7 (4): 441-51.

Nickavara B, Mojaba F, Javidniab K, Amolia MAR. Chemical composition of the fixed and volatile oils of Nigella sativa L. From Iran. Z. Naturforsch 2003; 58c, 629-1.

Farid BA, Aoumeur B, Brahim MY, Farid C. Chemical composition of seed essential oils from Algerian Nigella sativa extracted by microwave and hydrodistillation. Flavour and Fragrance journal 2007; 22 (2): 148-3.

Hutapea JR. Inventaris tanaman obat indonesia (III), Badan Penelitian dan Pengembangan Kesehatan, Depkes RI. 1994: 163-5.

Randhawa MA. An update on antimicrobial effect of Nigella sativa and experience at King faisal University, Dammam, Saudi Arabia. J Saudi Society Dermatol Dermatologic Surg 2008; 12: 37-44.

Farrakh KM, Atoji Y, Shimizu Farrakh KM, Atoji Y, Shimizu Y, Takewaki T. Isulinotropic properties of Nigella sativa oil in streptozotocin plus nicotinamide diabetic hamster. Res Vet Sci 2002; 73: 279-82.

El-Gazzar M, El-Mezayen R, Marecki JC, Nicolls MR, Canastar. Anti Inflammatory effect of thymoquinone in mouse model of allergic lung Inflammation. International immunopharmacology 2006; 6: 1135-42.

Maderuelo DL, Arnalich F, Serantes R, Gonzales A, Codoceo R, IFN-γ and IL-10 gene polymorphisms in pulmonary tuberculosis. Am J Respir Crit Care Med. 2003; 167: 970-5.

Vasto S, Malavolta M, Pawelec G. Age and immunity. Immunity & Ageing. 2006; 3 (2). 1-5.


  • There are currently no refbacks.

View My Stats



Creative Commons License

JR (p-ISSN: 2407-0831e-ISSN: 2621-8372) is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.