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Ethionamide induced hypothyroidism signs: The function of the thyroid gland in patients with multi-drug resistant tuberculosis

Two patients 6. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

David Stewart
Friday, October 6, 2017
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  • Search all BMC articles Search. In this review, we considered the presence of hypothyroidism if the authors of the included studies reported the prevalence in their results.

  • In: Harrison's Principles of Internal Medicine.

  • This difference might be due to differences in included studies or diagnosis upper limit used by the included studies. To compensate for hypothyroidism, patients with tuberculosis were prescribed L-thyroxine for 3 months or more.

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The study also did not measure the prevalence of iodine deficiency, although it should ethionamide induced hypothyroidism signs noted that India is among those countries where iodine intake tends to be adequate[ 37 ]. Performed if results are borderline and indication for treatment is unclear e. Medical School. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy.

Patient characteristics were summarized using descriptive statistics. Search all BMC articles Search. Ethionamide and PAS were the most frequently reported drugs that associated with the occurrence of hypothyroidism. Funding No funding was received. Eur Respir J 42 1 :

The study duration ranges from one month to 12 years [ Table 1 ]. View Article Google Scholar 9. International; Ethionamide induced hypothyroidism signs, UK; This approach prevents the emergence of symptomatic hypothyroidism in patients attending the MSF clinic. Ethionamide-Induced Goitrous Hypothyroidism. The minimum sample size used by the included studies was five participants [ 33 ] and the maximum [ 52 ] [ Table 1 ]. The Lancet.

1. Introduction

Recent Activity. The diagnosis hyppthyroidism established in the presence of resistance of mycobacterium tuberculosis, isolated from the sputum samples of patients, to isoniazid and rifampicin. Author information Affiliations Department of phtisiology and pulmonology, Kharkiv national medical university, Nauky lane, 4, Kharkiv,Ukraine S. Additional workup: Aside from TSH and T 4in myxedema coma: Obtain cortisol level as adrenal insufficiency needs to be treated. HIV-infected patients initiated on a multidrug-resistant TB regimen between October and March were eligible for enrolment in this study.

This content does not have an Arabic version. These children are also more prone to serious intellectual and developmental problems. Within 6 weeks of ethionamide withdrawal, ten patients Hypothyroidism was recorded in the majority Metrics details. At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain.

Click through the PLOS taxonomy to find articles in your field. Moreover, few ethionzmide reported the drugs and other associated factors on the hypothyroidism. The study was conducted in accordance with international standard ethical standards and issued using appropriate protocols and obtaining informed consent from all patients included in the study. Real study is undertaken as a prospective one to illuminate unclear points of the problem previously discussed. Sharada7 Sudhendra Kulkarni1 Vineet K. Improved capacity for MDR-TB case detection has also contributed to the increasing number of cases[ 1 ]. Analysis of thyroid function tests in patients of multidrug resistance tuberculosis undergoing treatment.

  • Global Tuberculosis Report Open in a separate window.

  • AIDS 14 8 : —

  • Thirty patients with multidrug-resistant tuberculosis were examined. Ethionamide: Unusual Cause of Hypothyroidism.

  • Matveyeva, S.

Ethionamide and PAS were the most frequently reported drugs that were associated with hypothyroidism. The function of the thyroid gland in patients with multi-drug resistant tuberculosis. The second-line anti-TB drugs associated with hypothyroidism include ethionamide, prothionamide, and PAS[ 2414 ]. Akshatha2 Shashidhar Buggi2 Manchenahalli A. Int J Tuberc Lung Dis. Conclusion This review revealed that hypothyroidism is not a rare adverse drug reaction in MDR-TB patients on treatment.

The administration of thyroxin at a dose of mcg for 4 weeks resulted in a decrease in goiter and restoration of thyroid function. Submitting a report will send us an email through hypothyroidism signs customer support system. Some patients initially enrolled in the program were treated for a duration of 18 months following the WHO guidelines at that time[ 4 ]. Other Nursing Career. More Information Hypothyroidism and joint pain? The aim of the study is to define the side effects of second line drugs used in the treatment of MDRTB on thyroid function. Monitoring and correction of thyroid function during antituberculosis chemotherapy was suggested.

Background

Co-administration of these two agents increased the risk of hypothyroidism by two-fold relative risk: 1. High rate of hypothyroidism among patients treated for multidrug-resistant tuberculosis in Lesotho. New Delhi.

South African Fam Pract. The function of the thyroid gland in patients etjionamide multi-drug resistant tuberculosis. Egyptian Journal of Chest Diseases and Tuberculosis. The treatment of MDR-TB is a difficult phenomenon that challenges patient management due to its long term treatment, expensive cost and severe adverse drug reactions [ 58 — 10 ]. Cite this article Matveyeva, S. View Article Google Scholar 6.

Monitoring TSH regularly in these cases helps assess the need for pharmacotherapy. Submit report Close. Article PubMed Google Scholar 2. Hypothyroidism: Can calcium supplements interfere with treatment? Diagnosis involves a multistep approach, which includes the determination of low cortisol levels, measuring ACTH, and determining if it is primary or secondary.

Peripheral neuropathy associated with treatment for multidrug-resistant tuberculosis. The aim of the study is to define signs side effects of second line drugs used in the treatment of MDR TB on thyroid function. The number of people being initiated on treatment for multidrug-resistant tuberculosis MDR-TB almost doubled between and as a result of steady annual increases in 12 of 27 countries having a high MDR-TB burden. Cite this article Matveyeva, S. Footnotes Conflict of Interest No conflicts declared. Ethionamide-lnduced Goitrous Hypothyroidism.

Table of Contents

Reactions Weekly, 1 Clinical features and detection of congenital hypothyroidism. Within 3 5 months of ethionamide therapy, the patients developed hypothyroidism. Hypothyroidism results when the thyroid gland fails to produce enough hormones. You can change your cookie settings through your browser.

Int J Tuberc Lung Dis 16 4 : In time new case-finding of subclinical hypothyroidism and etihonamide correction prevents developing of overt hypothyroidism and its correction strengthens immunity and improves treatment response toward antituberculosis chemotherapy. PLoS One14 6 :e, 18 Jun Eur J Endocrinol 6 : The diagnosis is made in infancy if a child is symptomatic, especially if other family members are affected. Share on whatsapp. Hormones produced by the thyroid gland — triiodothyronine T3 and thyroxine T4 — have an enormous impact on your health, affecting all aspects of your metabolism.

View Article Google Scholar 8. The overall pooled hypothyroidism prevalence was We qualitatively summarized the drugs associated with hypothyroidism and carried thyroid hypothyroidism guidelines summary sigs data analysis by STATA version In addition, access to quality assured laboratory diagnosis for such advanced test is a serious problem in low-income countries where the burden of MDR-TB is high [ 3031 ]. Although the effect of MDR-TB drugs on thyroid function is well cited in the literature [ 21 — 24 ], little is known about the exact mechanism through which these drugs influence thyroid function.

Background

A subscription may be required. Submitting a report will send us an email through our customer support system. Yaqoob A Subclinical hypothyroidism and its consequences. If ascites persists after treatment, a coexisting cause should be sought.

  • Meta-regression analysis We assessed the effects of year of study and sample size of each study on heterogeneity between studies using meta-regression model [ Table 4 ].

  • Informed consent to the patient was not obtained since the data used in the study were routinely collected for treatment monitoring.

  • Search all BMC articles Search. Endocr Connect.

  • HIV-infected patients initiated on a multidrug-resistant TB regimen between October and March were eligible for enrolment in this study.

  • Clin Infect Dis 37 4 :

  • Availability of data and materials All data generated or analysed during this study are included in this published article.

Annals of Internal Medicine. Geneva, Switzeland; Future studies are needed to find out the proportion of MDR-TB patients developing hypothyroidism during continuous phase as well, as susceptibility for hypothyroidism may continue ethionamide induced hypothyroidism signs IP. The functional state of the thyroid gland was assessed by the results of the study of the thyroid echostructure and the determination of serum levels of free thyroxine T4 and the thyroid-stimulating hormone of the pituitary TSH before the start of therapy, as well as at the end of the intensive phase and at the end of treatment. Undesirable effects on the thyroid gland are not seen but the side effects of para-aminosalicylic acid and ethionamide and their combinations are well known. View Article Google Scholar. Mediterr J Hematol Infect Dis.

Our policy towards the use of cookies All DeepDyve websites use cookies to improve your online experience. They may also have:. Table 2. Gerdes H. Nursing School. In: Ferri's Clinical Advisor The average age of the patients was

  • In our setting, we managed to prevent overt hypothyroidism by detecting it early and treating it promptly.

  • Babies born to women with untreated thyroid disease may have a higher risk of birth defects compared to babies born to healthy mothers. The obtained data allows making a conclusion about the suppressive effect of anti-tuberculosis drugs on the hormonal function of the thyroid gland of multidrug-resistant tuberculosis patients.

  • The study also did not measure the prevalence of iodine deficiency, although it should be noted that India is among those countries where iodine intake tends to be adequate[ 37 ]. High rate of hypothyroidism among patients treated for multidrug-resistant tuberculosis in Lesotho.

  • Your thyroid gland is located at the base of your neck, just below the Adam's apple. Browse Subject Areas?

  • View Article Google Scholar 4. Hypothyroidism is a common AE associated with ethionamide, p-aminosalicylic acid PASand stavudine.

Footnotes Conflict of Interest No conflicts declared. Abstract We followed 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. It is possible that some these patients may have suffered from hypothyroidism, thus underestimating incidence. View Article Google Scholar 4. The functional state of the thyroid gland was assessed by the results of the study of the thyroid echostructure and the determination of serum levels of free thyroxine T4 and the thyroid-stimulating hormone of the pituitary TSH before the start of therapy, as well as at the end of the intensive phase and at the end of treatment. Discussion Medications used to treat MDR-TB are known to cause multiple and severe adverse drug reactions that affect treatment outcome, treatment adherence and patient's quality of life [ 11 — 13 ]. Elsevier Ltd; ;9 3 —

Ethionamide induced hypothyroidism signs Available from publisher site using DOI. The mean level of TSH increased at the end of the intensive care phase from 1. This research was approved by protocol 9 of the sitting of the Commission on ethics and bioethics of Kharkiv national medical university at 2. Multidrug-resistant and exensively-resistant tuberculosis: a threat to global control of tuberculosis. This website requires cookies, and the limited processing of your personal data in order to function. Similarly sex was previously found to be associated with hypothyroidism in HIV-infected patients but we found no such association in our Mumbai cohort of co-infected patients on treatment[ 21 ]. Conceived and designed the experiments: PI.

Publication types

Studies included in this review ethionamide induced hypothyroidism signs reported from 19 countries which cover three continents Africa, Asia and Europe [ Table 1 ]. Lung India. This might limited our sub-group analysis to further explore the source of heterogeneity. Hypothyroidism during second-line treatment of multidrugresistant tuberculosis: A prospective study. Ethionamide: Unusual Cause of Hypothyroidism.

  • Author Contributions Conceived and designed the experiments: PI.

  • More Information Hypothyroidism symptoms: Can hypothyroidism cause eye problems?

  • The most frequently reported adverse drug reactions associated with MDR-TB drugs are skin rash, gastrointestinal symptoms, ototoxicity, electrolyte derangement, hepatotoxicity, nephrotoxicity, arthralgia, psychosis, suicidal tendencies, depression and hypothyroidism [ 121216 ].

In our study, lower CD4 cell hypoothyroidism were associated with hypothyroidism in bivariate analysis, which may be a result of HIV infection itself being associated with thyroid dysfunction. Second-line anti-TB drugs are more likely to cause adverse events AE than the first-line anti-tuberculosis drugs used in drug-sensitive TB treatment[ 21213 ]. View Article Google Scholar 9. J Clin Diagnositic Res. Browse Subject Areas? After the end of the course of chemotherapy, they should give up thyroxine.

ALSO READ: Euthyroid Sick Syndrome Vs Subclinical Hypothyroidism Icd 9

Antiretrovirals and drug-resistant TB drugs have potentially overlapping AEs[ 141920 ]. The remaining two patients were diagnosed at and days respectively. Article PubMed Google Scholar 2. International; Cornwall, UK; We included a cohort studies that reported the prevalence of hypothyroidism at least on five MDR-TB patients on treatment and conducted in different parts of the world.

Share on facebook. Int J Tuberc Lung Dis ethionamide induced hypothyroidism signs 12 : Ongoing efforts to find a better, more efficacious and less toxic second-line TB regimen requiring considerably shorter treatment duration should be the priority of the TB community. Learn even more with Lecturio:. Monitoring TSH regularly in these cases helps assess the need for pharmacotherapy. Sellmeyer DE, Grunfeld C Endocrine and metabolic disturbances in human immunodeficiency virus infection and the acquired immune deficiency syndrome.

Ethionamide

Elsevier Ltd; ; 18 —1. TSH testing can be challenging in resource-limited settings due to limited availability. Study inclusion and ijduced criteria We included a cohort studies that reported the prevalence of hypothyroidism at least on five MDR-TB patients on treatment and conducted in different parts of the world. Eligible studies were cross-sectional and cohort studies that included at least five participants. Diagnostics for Developing Countries.

  • Adverse effects of oral second-line antituberculosis drugs in children. As a result, the pooled odds ratio between female and male was 0.

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  • N Engl J Med.

  • Mediterr J Hematol Infect Dis. Recommendations Hypotbyroidism patients with MRD TB taking ethionamide and PAS submit monitoring of thyroid function by ultrasound and checking the levels of free thyroxine and thyroid stimulating hormone before the start of therapy, as well as at the end of the intensive phase and at the end of treatment.

All rights reserved Reactions 10 Mar No. At first, you may ethionamlde notice the symptoms of hypothyroidism, such as fatigue and weight gain. Age, gender, CD4 counts and stavudine-based ART were not associated with the occurrence of hypothyroidism in multivariate models. In our study, lower CD4 cell counts were associated with hypothyroidism in bivariate analysis, which may be a result of HIV infection itself being associated with thyroid dysfunction. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

All patients received therapy for drug-resistant TB DR-TB using hypothyridism model of care that involves ambulatory, community-based, hypothyroidism signs observed treatment DOT as previously described elsewhere[ 19 ]. Similar Articles To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. Data were routinely collected during each consultation and entered into handwritten patient files and an electronic database. The aim of the study is to define the side effects of second line drugs used in the treatment of MDR TB on thyroid function. The study also did not measure the prevalence of iodine deficiency, although it should be noted that India is among those countries where iodine intake tends to be adequate[ 37 ].

These inconsistences limited our analysis to further determine the signs source of heterogeneity on the prevalence of hypothyroidism. The obtained data allows making a conclusion about the suppressive effect of anti-tuberculosis drugs on the hormonal function of the thyroid gland of multidrug-resistant tuberculosis patients. J Biol Sci. We included 26 full articles, one letter to the editor [ 32 ] and three abstracts [ 33 — 35 ] that provided prevalence of hypothyroidism in MDR-TB patients on treatment [ Fig 1Table 1 ]. TSH testing can be challenging in resource-limited settings due to limited availability.

Modongo C, Zetola NM. Subclinical dysfunction of TSH level was diagnosed at the significance of more than 4. Funding: The authors have no support or funding to report.

Decreasing of thyroid function under antituberculosis chemotherapy was approved. Of the 47 patients excluded from the study Figure 118 of them did not have two TSH measurements i. Care providers should not wait for clinical symptoms, as this risks compromising treatment adherence. The side effects of these drugs are well documented, however, are often overlooked [ 4 — 6 ]. Indian J Rheumatol [Internet]. Introduction The number of people being initiated on treatment for multidrug-resistant tuberculosis MDR-TB almost doubled between and as a result of steady annual increases in 12 of 27 countries having a high MDR-TB burden.

WHO guidelines for programmatic onduced of drug-resistant tuberculosis recommend TSH monitoring summary least every 6 months while other guidelines advise screening every three months[ 24 ]. The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. Table of Contents. Goitre and hypothyroidism in the newborn after cutaneous absorption of iodine. Search all BMC articles Search. Co-infection with HIV was not discussed in either of these studies. Recommended Articles Loading

  • Meta-regression analysis We assessed the effects of year of study and sample size of each study on heterogeneity between studies using meta-regression model [ Table 4 ]. Comment Laboratory medicine in low-income and middle-income countries: progress and challenges.

  • Bolocadze E. Include any more information that will help us locate the issue and fix it faster for you.

  • Thus, measuring and accounting for baseline hypothyroidism is very important to estimate the independent prevalence of hypothyroidism due to MDR-TB drugs. Elsevier Ltd; ; 18 :1—

  • Indices of thyroid function: plasma levels of free thyroxin, thyroid stimulating hormone were studied before chemotherapy initiated, at the end of intensive phase and after the treatment finished.

  • Scientists aren't sure why this happens, but it's likely a combination of factors, such as your genes and an environmental trigger.

Int J Tuberc Lung Dis 11 12 : Fig 2 depicts the ethionamide induced hypothyroidism signs of studies identified by year of publication. Mcnerney R. The majority of studies eighteen reported the drugs that are associated with hypothyroidism [ Table 2 ], including Ethionamide, PAS, Kanamycin, Thioamide and Prothionamide [ Table 2 ]. Learn More.

J Fam Community Med. Hypothyrpidism review of literature on thyroid hormone disorders orginated from hypothyroidism signs thyroidal illiness. The remaining two patients were diagnosed at and days respectively. This finding was consistent with the previous review report that pooled the results of three studies in which the pooled prevalence of hypothyroidism was Supporting information. World Health Organization.

Accepted : 04 August The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis. The remaining two patients were diagnosed at and days respectively.

Ongoing efforts to find a better, more efficacious and less toxic second-line TB regimen requiring considerably shorter treatment duration should be the priority of the TB community. Jayachamarajapura S. Autoimmunity: From Bench to Bedside [Internet]. Modongo C, Zetola N. Abstract We followed 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.

Funding: The authors have no ethionamide induced hypothyroidism or funding to report. Med Sci Monit. We pooled data on 6, MDR-TB patients on treatment to estimate the pooled prevalence of hypothyroidism in this meta-analysis. Seventeen studies were reported from Asian [ 3234 — 4042 — 44464853546061 ], eight from African [ 4145474950555758 ] and five from European [ 3348525659 ] countries. View Article Google Scholar 9.

J Infect Dis. Second-line anti-TB drugs are more likely to cause adverse events AE than the first-line anti-tuberculosis drugs used in drug-sensitive TB treatment[ 21213 ]. Hypothyroidism is one of adverse drug reactions that cause life threatening conditions in patients [ 111718 ]. Antimicrob Resist Infect Control 6, 82

Competing interests The authors declare that they have no competing interests. Outcomes from the first multidrug-resistant tuberculosis programme in Kenya. For instance 11 studies ethionamide induced hypothyroidism signs not report the definition of hypothyroidism which might be the potential source of heterogeneity on the estimated prevalence. When patients required hospitalization, MSF collaborated with private and government hospitals; Sewri TB Hospital was the only government hospital in Mumbai having hospital wards designed to accommodate tuberculosis patients.

  • Guidelines for the programmatic management of drug-resistant tuberculosis update. Thyroid hypothyroidism guidelines summary The effect of anti-tuberculosis chemotherapy on thyroid function, especially hy;othyroidism as ethionamide and PAS, has been shown in a number of studies and was explained by a decrease in the systemic blood flow of thyroxine-binding protein, resulting in a decrease in the thyroid hormone content in the blood.

  • Registered Nurse RN.

  • Conclusions Thus, patients with MRD TB taking ethionamide and PAS are at increased risk for hypothyroidism and goiter, and therefore require monitoring of thyroid function at all stages of antituberculosis chemotherapy for its timely correction. Int J Tuberc Lung Dis 16 11 :

  • Two patients 6.

  • Chapter 30Thyroid disease and autoimmune diseases.

Funding No funding was received. Central hypothyroidism. More Information Htpothyroidism hypothyroidism signs joint pain? Smart citations by scite. D Drucker Search articles by 'D Drucker'. The number of people being initiated on treatment for multidrug-resistant tuberculosis MDR-TB almost doubled between and as a result of steady annual increases in 12 of 27 countries having a high MDR-TB burden. PloS ONE 4 9 : e

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Results Studies characteristics We included 26 full articles, one letter to the editor [ 32 ] and three abstracts ethionamlde 33 — 35 ] that provided prevalence of hypothyroidism in MDR-TB patients on treatment [ Fig 1Table 1 ]. Table 3 depicts subgroup analysis results based on study setting, study design, treatment regimen and continent from where the study was reported. NtlJ Comunity Med. There was a significant difference in the pooled prevalence of hypothyroidism within the group and between the groups during subgroup analysis. We performed bi- and multi-variate analyses to assess risk factors associated with the occurrence of hypothyroidism.

  • Data were routinely collected during each consultation and entered into handwritten patient files and an electronic database. The function of the thyroid gland in patients with multi-drug resistant tuberculosis.

  • Thyroid gland.

  • J Public Health Biol Sciences 1 2 : Eligible studies were cross-sectional and cohort studies that included at least five participants.

Submit report Close. Lancet Infect Dis All rights reserved Reactions 10 Mar No. The average age of the patients was A p-value of less than 0.

Side effects associated with the treatment of multidrug-resistant tuberculosis. S1 Checklist. References 1. Figure 2. Out of 69 patients analyzed as of March37 Infect Dis Clin North Am.

Undesirable effects on the thyroid gland are not seen but the side effects of para-aminosalicylic acid and ethionaamide and their combinations are well known. When patients required hospitalization, Ethionamide induced hypothyroidism signs collaborated with private and government hospitals; Sewri TB Hospital was the only government hospital in Mumbai having hospital wards designed to accommodate tuberculosis patients. The publisher's final edited version of this article is available at J Tuberc Res. PloS One. Background Multidrug-resistant tuberculosis MDR TB remains a health problem for many countries in the world [ 12 ].

N Engl Hhpothyroidism Med 26 : Multidrug-resistant tuberculosis MDR TB remains a health problem for many countries in the world [ 12 ]. Background Multidrug-resistant tuberculosis MDR TB remains a health problem for many countries in the world [ 12 ]. Thirty patients with multidrug-resistant tuberculosis were examined. Rochester, Minn.

Patients with mildly underactive subclinical thyroid have TSH levels of 4. Matveyeva 1O. Jameson JL, et al. Sellmeyer DE, Grunfeld C Endocrine and metabolic disturbances in human immunodeficiency virus infection and the acquired immune deficiency syndrome.

  • Copyright notice.

  • The time-to-hypothyroidism was measured using Kaplan-Meier analysis data were censored by 30 th March When newborns do have problems with hypothyroidism, the problems may include:.

  • Even mild or subclinical hypothyroidism should not be overlooked as it may increase the risk of co-morbidities such as depression[ 32 ]. Bolocadze E.

  • Lancet Infect Dis

Uypothyroidism Diagram. Under PMDT, serologic testing for thyroid-stimulating hormone TSHa hypothyroidism signs for thyroid functioning, is conducted only amongst MDR-TB patients who passively report experiencing signs and symptoms of hypothyroidism. Int J Tuberc Lung Dis 11 12 : Statistical processing of the obtained data was carried out by the method of variation statistics with the help of the standardized package of calculations of Microsoft Excel XP. This finding was consistent with the previous review report that pooled the results of three studies in which the pooled prevalence of hypothyroidism was Adverse events in the treatment of multidrug-resistant tuberculosis: results from the DOTS-Plus initiative.

Int J Tuberc Lung Dis 16 9 : Signa time-to-hypothyroidism was measured using Kaplan-Meier analysis data were censored by 30 th March Bolocadze E. Any signs who required immediate treatment was initiated on an empiric treatment regimen consisting of pyrazinamide, capreomycin, moxifloxacin, ethionamide, cycloserine, and PAS while awaiting the DST result; treatment was then either individualized once DST results became available, or the empiric regimen continued for culture-negative patients with a strong suspicion of drug-resistant TB based on TB treatment history. Ann Intern Med

References 1. Hypothyroidism associated with therapy for multi-drug-resistant tuberculosis in Australia. Read article at publisher's site DOI :

  • Co-infection with HIV was not discussed in either of these studies.

  • The appearance of goiter and hypothyroidism were detected under the influence of PAS at 8 months from the beginning of antituberculosis therapy. If you have signs or symptoms of myxedema, you need immediate emergency medical treatment.

  • Annals of Internal Medicine. Furthermore, Ethionamide and PAS were the most frequently reported drugs that were associated with the occurrence of hypothyroidism.

  • You can also search for this author in PubMed Google Scholar. Similarly sex was previously found to be associated with hypothyroidism in HIV-infected patients but we found no such association in our Mumbai cohort of co-infected patients on treatment[ 21 ].

  • BMJ Glob Heal.

  • Cited by: 1 article PMID: Methods Study design The study was a prospective, observational cohort study using routine clinical and laboratory data.

Our review indicated that hypothyroidism is not a rare drug adverse reaction in MDR-TB patients ethionamide induced hypothyroidism signs treatment. Patient characteristics, anti-tuberculosis drugs hypothtroidism, and TSH values were obtained from the PMDT register, treatment cards and laboratory reports. References 1. Twenty-three of these Some patients initially enrolled in the program were treated for a duration of 18 months following the WHO guidelines at that time[ 4 ]. PLoS Med.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. There can be a number of causes, including autoimmune disease, hyperthyroidism treatments, radiation therapy, thyroid surgery and certain medications. SOS — critical revision of the article; final approval of the version to be published. Int J Tuberc Lung Dis 16 9 : Until that happens, we need to reduce as much as possible the frequency of serious adverse events in MDR-TB patients with or without HIV co-infection by systematically screening to detect any adverse events early, including hypothyroidism. Ethionamide-induced hypothyroidism. Lancet

Skip to main content. The features of acquired hypothyroidism also reflect the effects of slowed organ function, such as fatigue, bradycardia, cold intolerance, and exertional dyspnea. Efavirenz, amprenavir, lopinavir, and ritonavir were also found to be associated with hypothyroidism[ 22 ]. Matveyeva 1O. Protease inhibitor-based regimens were used for patients in need of second-line and third-line ART. Goitre and hypothyroidism in the newborn after cutaneous absorption of iodine.

Monitoring TSH regularly in these cases helps assess the need for ethionamide induced. The side effects of these drugs are well documented, however, are often overlooked [ 4 — 6 ]. Is hypothyroidism rare in bypothyroidism resistance tuberculosis patients on treatment? Cited by: 1 article PMID: Any patient who required immediate treatment was initiated on an empiric treatment regimen consisting of pyrazinamide, capreomycin, moxifloxacin, ethionamide, cycloserine, and PAS while awaiting the DST result; treatment was then either individualized once DST results became available, or the empiric regimen continued for culture-negative patients with a strong suspicion of drug-resistant TB based on TB treatment history.

Please enable Javascript on your browser to continue. Copy and paste the desired citation format or use the link below to download a file formatted for EndNote. D Drucker Search articles by 'D Drucker'. Abstract Available from publisher site using DOI.

S1 Checklist. A major strength of this review is the inclusion of a large number of studies and the use of large sample size, which made the estimation of pooled prevalence of hypothyroidism more precise. Ann Intern Med We followed 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.

Download: PPT. Disclaimer The findings and conclusions in this paper are those of the authors and do not necessarily reflect the official position of the U. Ann Intern Med

There was no difference in the time-to-hypothyroidism between the patients who received both drugs and the ones who received just one of the two. Please review our privacy policy. The study was conducted in accordance with international signs ethical standards and issued using appropriate protocols and obtaining informed consent from all patients included in the study. The effect of anti-tuberculosis chemotherapy on thyroid function, especially such as ethionamide and PAS, has been shown in a number of studies and was explained by a decrease in the systemic blood flow of thyroxine-binding protein, resulting in a decrease in the thyroid hormone content in the blood. Series Pathology and laboratory medicine in low-income and Delivering modern, high-quality, affordable pathology and laboratory medicine to low-income and middle-income countries: a call to action.

J Tuberc Res. Corresponding author. AIDS 5 6 : Hypothtroidism, blood tests for T4 are still normal. Funding: The author s received no specific funding for this work. In the event of drug intolerance or severe adverse reactions to kanamycin and cycloserine, paraaminosalicylate sodium PAS may be used as a substitute drug [ 3 ].

Read article at publisher's site DOI : Soy: Does it worsen hypothyroidism? Table 1. Chapter 4. Two patients 6.

Received : 02 May Twenty studies were clearly defined hypothyroidism, hypothyrodism eleven studies did not provide the definition of hypothyroidism [ Table 1 ]. Author manuscript; available in PMC Sep 1. A poor quality study was scored 0 or 1 star in participant selection, 0 stars in comparability of the groups and 0 or 1 star in outcome s assessment. Chapter 30Thyroid disease and autoimmune diseases.

Availability of data and materials All data generated or analysed during this ethionamide induced hypothyroidism signs are included in this published article. In a multivariate analysis of a study of HIV patients receiving ART, cumulative dosing of stavudine was associated with subclinical hypothyroidism[ 21 ]. There can be a number of causes, including autoimmune disease, hyperthyroidism treatments, radiation therapy, thyroid surgery and certain medications. Data were routinely collected during each consultation and entered into handwritten patient files and an electronic database.

Please review our privacy policy. We followed 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. A good quality study was scored 3 ethionamide induced hypothyroidism signs 4 stars in participant selection, 1 or 2 hypothyroidksm in comparability of groups, and 2 or 3 stars in outcome s assessment. Subgroup analysis based on study setting, study design, regimen type and continent from where the study reported. In addition, larger scale prospective study is so important to further explore the effect of MDR-TB drugs on thyroid hormone function while controlling baseline hypothyroidism and other confounding factors. Subgroup analysis Table 3 depicts subgroup analysis results based on study setting, study design, treatment regimen and continent from where the study was reported. Tubercle and Lung Disease Rapid changes in thyroid function tests upon treatment of tuberculosis.

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