High rate of hypothyroidism among patients treated for multidrug-resistant tuberculosis in Lesotho
OBJECTIVE: To report the high rate of hypothyroidism in a cohort of MDR-TB patients in Lesotho and to describe our approach to diagnosis and management.
DESIGN: A retrospective study of 212 patients who initiated treatment for MDR-TB in Lesotho between 27 July 2007 and 24 March 2009 was performed.
RESULTS: Among 186 patients screened, 129 (69%) had hypothyroidism, defined as at least one documented thyroid-stimulating hormone (TSH) result > 10.0 mIU/l; 100 (54%) patients had a maximum TSH > 20.0 mIU/l. At 93 days after starting MDR-TB treatment, half of the patients had developed hypothyroidism.
CONCLUSION: Hypothyroidism may be more common during MDR-TB treatment than previously recognized. Screening all patients, even those without symptoms, for hypothyroidism within 2–3 months of starting MDR-TB treatment should be considered until prospective studies can inform screening guidelines.
Document Type: Research Article
Affiliations: 1: Partners In Health Lesotho, Maseru, Lesotho; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA 2: Partners In Health Lesotho, Maseru, Lesotho 3: Nutritional Intervention Research Unit, Medical Research Council, Tygerberg, Cape Town, South Africa 4: Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA 5: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA; and Partners in Health, Boston, Massachusetts, USA 6: Partners In Health Lesotho, Maseru, Lesotho; Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
Publication date: 2012-04-01
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