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Free Content High rate of hypothyroidism among patients treated for multidrug-resistant tuberculosis in Lesotho

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BACKGROUND: Hypothyroidism is a known side effect of treatment for multidrug-resistant tuberculosis (MDR-TB), but it is considered to be rare. Hypothyroidism has vague and non-specific symptoms, and can be easily missed by clinicians.

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.
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Keywords: adverse reactions; multidrug-resistant tuberculosis; thyroid

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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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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