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The spectrum of endocrine dysfunction in active pulmonary tuberculosis
F A Post1, S G Soule, P A Willcox
1Department of Medicine, University of Cape Town, South Africa.
Clinical Endocrinology
|March 1, 1994
Summary
Hypoadrenalism is rare in active pulmonary tuberculosis (TB). However, patients frequently experience thyroid dysfunction and hypogonadotrophic hypogonadism, indicating broader endocrine system impacts of TB.
Area of Science:
- Endocrinology
- Infectious Diseases
- Pulmonology
Background:
- Prevalence of hypoadrenalism in tuberculosis (TB) varies significantly, ranging from 0% to 55%.
- Active pulmonary TB can affect various endocrine axes, necessitating comprehensive evaluation.
Purpose of the Study:
- To prospectively assess adrenal, thyroid, and gonadal function in patients with active pulmonary TB.
- To clarify the incidence of hypoadrenalism in this patient population.
Main Methods:
- A prospective study involving 50 hospitalized adult patients with newly diagnosed sputum-positive pulmonary TB.
- Adrenal reserve was evaluated using tetracosactrin stimulation test, measuring basal and stimulated cortisol.
- Basal ACTH, thyroid hormones, and gonadal hormones were also assessed.
Main Results:
- All 50 patients demonstrated intact adrenal reserve, with stimulated cortisol levels exceeding 550 nmol/l.
- Sick euthyroid syndrome was observed in 92% of patients.
- Hypogonadotrophic hypogonadism was present in 72% of males.
Conclusions:
- Hypoadrenalism is uncommon in active pulmonary TB.
- Thyroid and gonadal axes frequently exhibit dysfunction in patients with active pulmonary TB.