The spectrum of endocrine dysfunction in active pulmonary tuberculosis.
Clin Endocrinol (Oxf)
; 40(3): 367-71, 1994 Mar.
Article
en En
| MEDLINE
| ID: mdl-8187301
ABSTRACT
OBJECTIVE:
Substantial variation in the prevalence (0-55%) of hypoadrenalism in tuberculosis (TB) has been reported. The aim of this study was to prospectively evaluate adrenal, thyroid and gonadal function in patients presenting with active pulmonary TB.DESIGN:
A prospective study of 50 patients admitted to a single hospital. PATIENTS Fifty hospitalized adults with newly diagnosed sputum positive pulmonary TB (mean age 38 years, mean body mass index 18 kg/m2, mean albumin 28 g/l) were studied. MEASUREMENTS Adrenal reserve was assessed by intravenous tetracosactrin administration with measurement of basal and stimulated cortisol concentrations. Basal ACTH, thyroid and gonadal hormones were also measured.RESULTS:
The mean basal serum cortisol was 625 nmol/l (range 394-1185). Basal plasma ACTH was undetectable (< 4.4 pmol/l) in 32, normal in 17 (mean 11.45, range 4.4-24.9 pmol/l) and elevated in one (54.2 pmol/l) subjects and did not correlate with cortisol. The mean increment in cortisol following tetracosactrin was 256 nmol/l (range 0-650) and was unrelated to basal cortisol or ACTH. All 50 patients had a stimulated plasma cortisol exceeding 550 nmol/l, indicating intact adrenal reserve. Ninety-two per cent of patients had the sick euthyroid syndrome, 72% of males had hypogonadotrophic hypogonadism and 4% of patients tested positive for the human immunodeficiency virus.CONCLUSIONS:
Hypoadrenalism is uncommon in active pulmonary TB despite frequent dysfunction of the thyroid and gonadal axes.
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Bases de datos:
MEDLINE
Asunto principal:
Testículo
/
Glándula Tiroides
/
Tuberculosis Pulmonar
/
Glándulas Suprarrenales
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Endocrinol (Oxf)
Año:
1994
Tipo del documento:
Article
País de afiliación:
Sudáfrica