Thyroid profile in pulmonary tuberculosis patients: a prospective study in a tertiary medical college of southern Odisha

Manoranjan Dash; Bibhu P. Behera; Ranjan Kumar Sen

doi:10.18203/2349-3259.ijct20200538

Authors

Manoranjan Dash Department of Chest and TB, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India
Bibhu P. Behera Department of Internal Medicine, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India
Ranjan Kumar Sen Department of Internal Medicine, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20200538

Keywords:

Pulmonary tuberculosis, Thyroid profile, Sick-euthyroid, Hypothyroid, Hyperthyroid

Abstract

Background: Globally, an estimated 10.0 million (range, 9.0 to 11.1 million) people infected with tuberculosis (TB). Developing country like India accounts for one fourth of the global tuberculosis burden. TB is associated with diffuse functional impairment of most endocrine organs.

Methods: We conducted a study to evaluate the thyroid profile status in new sputum positive pulmonary tuberculosis patients, aged 12 years and above; attended and admitted to chest and TB, Medicine Department of SLN MCH, Koraput, Odisha from January 2019 to December 2019. Patients with H/o old pulmonary tuberculosis, patient with known neurological, hypothalamic-pituitary or thyroid disorders, kidney disease, malignancies and patients receiving medications known to interfere with thyroid hormone metabolism were excluded from the study. Statistical analysis was done by using SPSS version 21.0 software. Results were expressed in average±SD, frequencies and percentages. Continuous data were compared using Student’s t-test. A p value <0.05 was considered as statistically significant and p value <0.001 was considered as statistically extremely significant.

Results: Mean age of the study group was 37.31±15.63 years. 54 patients (40.30%) were in 20 to 40 years of age group. We found, 48 (35.82%) pulmonary tuberculosis patients had sick euthyroid syndrome out of 134 pulmonary tuberculosis patients.

Conclusions: Sick euthyroid syndrome occurs commonly in pulmonary tuberculosis patients with increasing incidence with advanced age, and also seen in patients with advanced pulmonary tuberculosis patients; therefore, requires monitoring of thyroid function test for its timely initiation of therapy.

Metrics

Metrics Loading ...

Author Biography

Manoranjan Dash, Department of Chest and TB, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India

INTERNAL MEDICINE, ASSISTANT PROFESSOR

References

Global tuberculosis report 2015 (WHO/HTM/TB/2015.22). Geneva: World Health Organization; 2015. Available at: https://apps.who. int/iris/bitstream/handle/10665/191102/9789241565059_eng.pdf;jsessionid=257E179B7641F5CE7FD14BEF18488436?sequence=1. Accessed on 10 January 2020.

Global tuberculosis report 2018. Geneva: World Health Organization; 2018. Available at: https://apps.who.int/iris/handle/10665/274453. Accessed on 10 January 2020.

Global tuberculosis report 2019. Geneva: World Health Organization; 2019. License: CC BY-NC-SA 3.0 IGO. Available at: https://creativecommons. org/licenses/by-nc-sa/3.0/igo. Accessed on 10 January 2020.

Technical and Operational Guidelines for TB Control in India 2016: Central TB Division. Available at https://tbcindia.gov.in. Accessed on 10 January 2020.

Wartofsky L, Barman KD. Alterations in thyroid function in patients with systemic illness: the 'euthyroid sick syndrome'. Endocr Rev. 1982;3:164-217.

Chopra IJ, Hershman 1M, Pardridge WM, Nicoloff IT. Thyroid function in nonthyroidal illness. Ann Intern Med. 1983;98:947-57.

Sheppard MC, Ramsden DB. Abnormalities of thyroid function test in hospital in-patients. Postgrad Med J. 1985;61:983-7.

Sharma SK, Mohan A editors. Tuberculosis. 2. ed., repr. New Delhi: Jaypee Brothers Medical Publishers; 2011: 1052.

Aatif S, Qamar R, Ahmed I, Imran K. Sick euthyroid syndrome: Thyroid function abnormalities in patientswith non-thyroid illness. JLUMHS. 2008;7(2):83-6.

Maldonado LS, Murata GH, Hershman JM, Braunstein GD. Do thyroid function test independently predict the survival in the critically ill? Thyroid. 1992;2(2):119-23.

Aatif S, Qamar R, Imran IA and K. Sick euthyroid syndrome: thyroid function abnormalities in patients with non-thyroid illness. J Liaquat Univ Med Health Sci. 2008;7(2):83-6.

Lee S, Farwell AP. Euthyroid sick syndrome. Compr Physiol. 2016;6(2):1071-80.

Thomas BE, Thiruvengadam K, Kadam D, Ovung S, Sivakumar S, Bala Yogendra Shivakumar SV, et al. Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored. PLoS One. 2019;14(7):1-12.

Varghese V, Menon KS, Green SR. Effect of anti-tuberculosis treatment on thyroid profile in newly detected smear positive pulmonary tuberculosis cases. Int J Adv Med. 2018;5:688-93.

Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. Study, The Prevalence and Evolution of Anemia Associated with Tuberculosis; J Korean Med Sci. 2006;21(6):1028–32.

Kaplan FJ, Levitt NS, Soule SG. Primary hypoadrenalism assessed by the 1 microg ACTH test in hospitalized patients with active pulmonary tuberculosis. QJM. 2000;93:603-9.

Post FA, Soule SG, Wiilcox PA, Levitt NS. The spectrum of endocrine dysfunction in active pulmonary tuberculosis. Clin Endocrinol (Oxf). 1994;40:367-71.