Drug-induced hypothyroidism in tuberculosis.

Autor:	Quiroz-Aldave JE; Division of Non-communicable diseases, Endocrinology research line, Hospital de Apoyo Chepén, Chepén, Perú., Durand-Vásquez MDC; Division of Non-communicable diseases, Endocrinology research line, Hospital de Apoyo Chepén, Chepén, Perú., Gamarra-Osorio ER; Division of Endocrinology, Hospital Víctor Lazarte Echegaray, Trujillo, Perú., Concepción-Urteaga LA; Division of Pneumology, Hospital Regional Docente de Trujillo, Trujillo, Perú., Pecho-Silva S; Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Perú.; Division of Pneumology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú., Rodríguez-Hidalgo LA; Division of Pneumology, Hospital Regional Docente de Trujillo, Trujillo, Perú., Concepción-Zavaleta MJ; Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Perú.
Jazyk:	angličtina
Zdroj:	Expert review of endocrinology & metabolism [Expert Rev Endocrinol Metab] 2024 May; Vol. 19 (3), pp. 199-206. Date of Electronic Publication: 2024 Jan 23.
DOI:	10.1080/17446651.2024.2307525
Abstrakt:	Introduction: Adverse reactions to tuberculosis treatment can impact patient adherence and prognosis. Hypothyroidism is a frequent adverse reaction caused using ethionamide, prothionamide, and para-aminosalicylic acid and is often underdiagnosed. Areas Covered: We searched Scielo, Scopus, and EMBASE databases, including 67 articles. Antitubercular drug-induced hypothyroidism has a prevalence of 17%. It occurs after 2 to 3 months of treatment and resolves within 4 to 6 weeks after discontinuation. It is postulated to result from the inhibition of thyroperoxidase function, blocking thyroid hormone synthesis. Symptoms are nonspecific, necessitating individualized thyroid-stimulating hormone measurement for detection. Specific guidelines for management are lacking, but initiation of treatment with levothyroxine, as is customary for primary hypothyroidism, is recommended. Discontinuation of antitubercular drugs is discouraged, as it may lead to unfavorable consequences. Expert Opinion: Antitubercular drug-induced hypothyroidism is more common than previously thought, affecting one in six MDR-TB patients. Despite diagnostic and treatment recommendations, implementation is hindered in low-income countries due to the lack of certified laboratories. New drugs for tuberculosis treatment may affect thyroid function, requiring vigilant monitoring for complications, including hypothyroidism.
Databáze:	MEDLINE
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