在结核病中的药物诱导的甲状腺功能低下症
Juan Eduardo Quiroz-Aldave1, María Del Carmen Durand-Vásquez1, Elman Rolando Gamarra-Osorio2
1Division of Non-communicable diseases, Endocrinology research line, Hospital de Apoyo Chepén, Chepén, Perú.
Expert review of endocrinology & metabolism
|January 23, 2024
概括
药物诱导的甲状腺功能低下是结核病治疗的常见不良反应,影响了17%的患者. 建议在早期测量甲状腺刺激激素和使用levothyroxine治疗,不建议停止使用结核病药物.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 结核病治疗的不良反应可能会对患者的坚持和结果产生负面影响.
- 甲状腺功能低下症是常见的,往往被低诊断的,对埃西奥纳米德,胺胺和副氨酸的不良反应.
研究的目的:
- 审查抗结核药物诱导的甲状腺功能低下的患病率,临床表现和管理.
- 强调在结核治疗期间监测甲状腺功能的重要性.
主要方法:
- 在Scielo,Scopus和EMBASE数据库中进行了系统的文献搜索.
- 综述中包括了67篇文章.
主要成果:
- 抗结核药物诱导的甲状腺功能低下症影响了17%的患者,通常在治疗2-3个月后出现,并在药物停止后4-6周内消失.
- 这种情况被认为是由于抑制了甲状腺激素酶的功能,损害了甲状腺激素的合成.
- 症状是非特异性的,强调需要个性化甲状腺刺激激素测量来诊断.
结论:
- 抗结核药物诱导的甲状腺功能低下比以前认可的更为普遍,特别是在多耐药结核病 (MDR-TB) 患者中.
- 建议使用levothyroxine治疗,类似于初级甲状腺功能低下症的治疗,同时应避免停止服用抗结核药物.
- 由于实验室资源有限,在低收入环境中实施诊断和管理策略具有挑战性;在新的结核病药物中,对甲状腺功能低下症的警监测至关重要.
相关概念视频
01:29Pulmonary Tuberculosis I
243
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
243
01:28Pulmonary Tuberculosis V
180
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
180
01:26Pulmonary Tuberculosis IV
143
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
143
01:31Pulmonary Tuberculosis III
332
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
332
01:28Pulmonary Tuberculosis II
239
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
239
01:20Synthesis and Regulation of Thyroid Hormones
4.6K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.6K