Adrenal function in patients with active tuberculosis.

D J Barnes, S Naraqi, P Temu, J R Turtle

Department of Clinical Sciences, University of Papua New Guinea, Port Moresby.

Although tuberculosis is a recognised cause of adrenal insufficiency, little is known about adrenal function in patients with active tuberculosis. Ninety Melanesian adults with active tuberculosis (30 pulmonary, 30 miliary, 30 extrapulmonary) had adrenal function assessed prospectively before and three to four weeks after starting antituberculous chemotherapy. Basal serum cortisol concentrations were normal in 55 (61%) and raised in 35 (39%) of the subjects. No patient had a low basal cortisol concentration. After Synacthen stimulation, cortisol responses were normal in 81 (92%) of the patients and subnormal in seven (8%). After antituberculous chemotherapy the response to Synacthen stimulation was normal in all but one patient. It is concluded that adrenal dysfunction is an uncommon problem in patients with active tuberculosis, and that, contrary to recent reports, antituberculous chemotherapy regimens that include rifampicin do not have an adverse effect on adrenal function.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• BAKER, R. W., WALKER, B. R., SHAW, R. J., HONOUR, J. W., JESSOP, D. S., LIGHTMAN, S. L., ZUMLA, A., ROOK, G. A. W. (2000). Increased Cortisol . Cortisone Ratio in Acute Pulmonary Tuberculosis. Am. J. Respir. Crit. Care Med. 162: 1641-1647 [Abstract] [Full Text]  
• Kaplan, F.J.L., Levitt, N.S., Soule, S.G. (2000). Primary hypoadrenalism assessed by the 1 {micro}g ACTH test in hospitalized patients with active pulmonary tuberculosis. QJM 93: 603-609 [Abstract] [Full Text]