Sharma, S. K. ; Tandan, S. M. ; Saha, P. K. ; Gupta, N. ; Kochupillai, N. ; Misra, N. K. (2005) Reversal of subclinical adrenal insufficiency through antituberculosis treatment in TB patients: a longitudinal follow up Indian Journal of Medical Research, 122 (2). pp. 127-131. ISSN 0971-5916
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Abstract
Background & Objective: Subclinical adrenal insufficiency has been shown to occur in patients with tuberculosis. Whether this insufficiency can be reversed with therapy and on long-term follow up, is not known. We studied the effect of antituberculosis treatment (ATT) with respect to reversal of the adrenal insufficiency, as assessed by response to standard dose adrenocorticotropin (ACTH) stimulation test in TB patients. Methods: One hundred and five HIV-negative tuberculosis patients were studied. Of these, 72 patients had pulmonary and 33 had extrapulmonary forms of the disease. Baseline (pre-treatment) standard-dose ACTH stimulation test was done on all the subjects, following which, they were put on standard antituberculosis therapy, depending on the type of disease and were followed up for a period of 30 months. ACTH stimulation tests were performed at follow up, every 6 months. Results: Baseline (pre-treatment) standard-dose ACTH stimulation test revealed an impaired response in 52 of 105 patients (49.5%). At 6 months, the percentage of responders had increased to 71 per cent with a gradual increasing trend noted thereafter. At 24 months, 31 of the 32 patients (97%) who were followed up demonstrated a normal response to ACTH stimulation. The percentage of responders was comparable in both pulmonary [21 of 22 patients (95%)] and extrapulmonary TB [10 of 10 patients (100%)] groups at follow up. Interpretation & Conclusion: Our study shows that nearly half of patients with active tuberculosis had a subclinical adrenal insufficiency indicated by an impaired response to ACTH stimulation test. This insufficiency reverse with therapy in most patients on long-term follow up.
Item Type: | Article |
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Source: | Copyright of this article belongs to Indian Council of Medical Research. |
Keywords: | ACTH Stimulation Test; Antituberculosis Treatment; Subclinical Adrenal Insufficiency; Tuberculosis |
ID Code: | 69227 |
Deposited On: | 08 Nov 2011 11:27 |
Last Modified: | 18 May 2016 15:43 |
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