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Adrenocortical reserve and morphology in tuberculosis
G A Prasad1, S K Sharma, A Mohan
1Department of Medicine, All India Institute of Medical Sciences, New Delhi.
The Indian Journal of Chest Diseases & Allied Sciences
|August 1, 2000
Summary
Subclinical adrenal insufficiency is common in tuberculosis patients, impacting adrenal reserve. Treatment for tuberculosis can reverse this adrenal compromise and gland enlargement.
Area of Science:
- Endocrinology
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) is a global health challenge.
- Malnutrition is common in TB patients.
- Adrenal function in TB is not well understood.
Purpose of the Study:
- To investigate adrenal reserve and morphology in HIV-negative TB patients.
- To assess the impact of anti-tuberculosis therapy on adrenal function.
Main Methods:
- ACTH (cosyntropin) stimulation tests were performed on TB patients and controls.
- Adrenal gland morphology was assessed using abdominal CT scans.
- Adrenal function was re-evaluated after 6-12 months of treatment.
Main Results:
- TB patients showed significantly lower cortisol levels post-ACTH stimulation compared to controls.
- Nearly 50% of TB patients had compromised adrenal reserve.
- Adrenal gland enlargement was observed in some TB patients, particularly those with drug-resistant TB.
- Adrenal function improved significantly after anti-tuberculosis therapy.
Conclusions:
- Subclinical adrenal insufficiency is prevalent in TB patients.
- Adrenal gland enlargement may be associated with TB, especially drug-resistant forms.
- Anti-tuberculosis treatment can reverse adrenal insufficiency and gland enlargement.