Vol. 5, Issue 7 (2019)
Evaluation of thyroid profile in euthyroid patients taking first line antitubercular drugs in newly detected smear positive pulmonary tuberculosis patient
Author(s): Dr. Pankaj Kumar
Abstract: Background: Pulmonary tuberculosis is a common contagious disease and has a capacity for wide spread dissemination. Present study aims to identify the effect of antituberculous treatment on thyroid profile in new smear positive pulmonary tuberculosis patients. The most common manifestation of thyroid dysfunction in these patients was found to be sick euthyroid syndrome. Many studies were done in MDR TB patients to know the incidence of drug induced hypothyroidism. Even though thyroid function is mandatory test before the initiation of MDR TB drugs, no such protocols exist in new smear positive pulmonary tuberculosis patients. Hence present study was planned to evaluate the effect of first line antitubercular drugs on thyroid function in new smear positive pulmonary tuberculosis patients. Methods: The present study was planned in Department of General Medicine, ICARE Institute of Medical Science and Research and Dr Bidhan Chandra Roy Hospital, Haldia. The study was planned from Sept 2012 to July 2013. Total 50 cases of the firstly diagnosed smear positive pulmonary tuberculosis patients from our hospital were enrolled in present study. In these selected cases Thyroid function was assessed by measuring free T3, free T4 and TSH value before and after initiating first line 4 drug regimen antitubercular therapy (ATT) and after 3 months of completion of ATT therapy. Patients are started on antituberculosis treatment as per current RNTCP guidelines. Thyroid function testing is repeated at the end of third month and at the end of 6 months and after 3 months of completion of ATT course. Result: The data generated from the present study concludes that Sick euthyroid syndrome was found to be a temporary reversible condition with highest incidence at the end of three months and was significantly reducing towards the end of treatment and cured after 3 months of stoppage of treatment, however none of these patients were acutely sick during the study and all these patients were euthyroid at the beginning of present study. Conclusion: The common Thyroid Dysfunction seen during the study period was Sick euthyroid and subclinical hypothyroidism. Anti-tuberculous medication probably Rifampicin would explain the cause for these thyroid dysfunctions noticed during the study time. And author recommend that these patients should be kept under follow up after the diagnosis instead of treating with thyroid supplements. And thyroid supplement should be given in clinically overt hypothyroid cases
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