TITLE:
Drug-Induced Hypothyroidism during Anti-Tuberculosis Treatment of Multidrug-Resistant Tuberculosis: Notes from the Field
AUTHORS:
Somashekar Munivenkatappa, Singarajipura Anil, Balaji Naik, Tyson Volkmann, Karuna D. Sagili, Jayachamarajapura S. Akshatha, Shashidhar Buggi, Manchenahalli A. Sharada, Sudhendra Kulkarni, Vineet K. Chadha, Patrick K. Moonan
KEYWORDS:
Hypothyroidism, Multidrug Resistance, Tuberculosis, Thyroid-Stimulating
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.4 No.3,
August
23,
2016
ABSTRACT: 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.