Prevalence of Adrenal Insufficiency and Adrenal Morphology in Treatment‐Naïve Tuberculosis Patients: A Cross‐Sectional Study From a High‐Burden Region
Authors' conclusion
AI is rare (1%) in treatment-naïve TB patients despite the overlapping clinical features in a significant proportion. Subtle adrenal morphological changes without enlargement suggest early TB-related alterations without overt dysfunction. Future research should prioritize larger TB cohorts including Extrapulmonary TB to enhance detection of adrenal pathology while minimizing radiation exposure with detailed immune assessments.
Study context
- Population
- Adults with newly diagnosed, treatment-naïve tuberculosis (TB) at Revised National Tuberculosis Control Program (RNTCP) clinics, Thiruvananthapuram (Kerala); HIV, uncontrolled DM, critical illness or recent steroid use excluded
- Participants
- 100 adults
- Outcome
- Prevalence of AI (peak cortisol <17 μg/dL at 60 min and <19.5 μg/dL at 120 min after IM long-acting porcine ACTH)
Main finding
As reported in the abstract
Adrenal insufficiency (AI) diagnosed (one patient with EPTB)
1
1%
AI in patients with PTB
0
Observational data: associations, not effects.
Further findings
Clinical features suggestive of AI
- Patients with clinical features suggestive of AI
- 27 (27%)
Peak serum cortisol
- Mean peak cortisol at 60 min
- 35.17 ± 10.77 μg/dL
- Mean peak cortisol at 120 min
- 39.67 ± 10.84 μg/dL
Adrenal morphology on CT, TB patients vs healthy controls
- Right adrenal Hounsfield unit (HU) density significantly reduced in TB patients vs controls
- P = 0.02
- Lateral limb thickness significantly reduced in TB patients vs controls
- P = 0.01
- No adrenal enlargement
- CT subset: 1 AI patient, 14 TB patients without AI, 18 age-matched healthy controls
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →