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Adreno-cortical reserve in pulmonary tuberculosis
1Department of Pulmonary Medicine and Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
The Journal of the Association of Physicians of India
|August 1, 1992
Summary
Patients with pulmonary tuberculosis show impaired adrenal cortical reserve. ACTH stimulation revealed significantly lower cortisol responses, indicating a functional deficit in these patients.
Area of Science:
- Endocrinology
- Infectious Diseases
- Pulmonology
Background:
- Pulmonary tuberculosis (TB) is a significant global health challenge.
- The adrenal glands' function in TB patients is not fully understood.
- Adrenal insufficiency can complicate various chronic infections.
Purpose of the Study:
- To evaluate the adrenal cortical reserve in patients with pulmonary tuberculosis.
- To assess the serum cortisol response to adrenocorticotropic hormone (ACTH) stimulation in TB patients.
- To compare adrenal function between TB patients and healthy controls.
Main Methods:
- Serum cortisol levels were measured in 28 patients with pulmonary tuberculosis and 10 healthy controls.
- Patients underwent ACTH stimulation testing to assess adrenal response.
- Basal cortisol levels, peak cortisol, and the area under the response curve were analyzed.
Main Results:
- Basal serum cortisol levels were comparable between TB patients and controls.
- Mean delta peak, mean, and area under the cortisol response curve were significantly lower in TB patients (p < 0.05 to 0.001).
- Six patients had negligible and five had inadequate cortisol responses to ACTH stimulation, despite no clinical signs of adrenal insufficiency.
Conclusions:
- Patients with pulmonary tuberculosis exhibit a functional impairment of their adrenal cortical reserve.
- Subclinical adrenal dysfunction may be present in pulmonary TB.
- Further investigation into the clinical implications of impaired adrenal reserve in TB is warranted.