Author(s)

Somashekar Munivenkatappa^1,2*, Singarajipura Anil³, Balaji Naik⁴, Tyson Volkmann⁵, Karuna D. Sagili⁶, Jayachamarajapura S. Akshatha², Shashidhar Buggi², Manchenahalli A. Sharada⁷, Sudhendra Kulkarni¹, Vineet K. Chadha⁷, Patrick K. Moonan^5*

¹Drug Resistant Treatment Centre, Bengaluru, India.
²Sri Devarao Shivaram, Tuberculosis and Rajiv Gandhi Institute of Chest Diseases, Bengaluru, India.
³Revised National Tuberculosis Programme-State of Karnataka, Bengaluru, India.
⁴World Health Organization, India Country Office, New Delhi, India.
⁵U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁶International Union against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India.
⁷National Tuberculosis Institute, Bengaluru, India.

We followed 188 euthyroidic persons undergoing treatment for multidrug resistant tuberculosis (MDR-TB) in the state of Karnataka, India to determine the incidence of hypothyroidism during anti-tuberculosis treatment. Overall, among MDR-TB patients with valid thyroid stimulating hormone (TSH) values, about 23% developed hypothyroidism (TSH value ≥10 mIU/ml) during anti-tuberculosis treatment; the majority (74%) occurring after 3 months of treatment. Among 133 patients who received a regimen that contained ethionamide, 42 (32%) developed hypothyroidism. Among 17 patients that received a regimen that contained para-aminosalicylate sodium, 6 (35%) developed hypothyroidism. Among 9 HIV positive patients on antiretroviral treatment, 4 (44%) developed hypothyroidism. These results differ from previously reported 4% incidence of hypothyroidism amongst patients who passively reported thyroidal symptoms during treatment, suggesting routine serologic monitoring of TSH throughout the course of treatment for MDR-TB is warranted.

Hypothyroidism, Multidrug Resistance, Tuberculosis, Thyroid-Stimulating

Munivenkatappa, S. , Anil, S. , Naik, B. , Volkmann, T. , Sagili, K. , Akshatha, J. , Buggi, S. , Sharada, M. , Kulkarni, S. , Chadha, V. and Moonan, P. (2016) Drug-Induced Hypothyroidism during Anti-Tuberculosis Treatment of Multidrug-Resistant Tuberculosis: Notes from the Field. Journal of Tuberculosis Research, 4, 105-110. doi: 10.4236/jtr.2016.43013.