Endocrine Dysfunction Among Adult Patients with Tuberculosis: An African Experience

Overview

Journal Indian J Endocrinol Metab

Specialty Endocrinology

Date 2014 Jun 20

PMID 24944920

Citations 5

Authors

Davis Kibirige

Affiliations

Soon will be listed here.

Abstract

A broad spectrum of endocrine conditions has been reported among adult patients with tuberculosis in Africa. This review aims to describe the magnitude and pathogenesis of the following endocrinopathies among patients with tuberculosis in Africa: adrenal insufficiency, diabetes mellitus, disorders of calcium and vitamin D metabolism, thyroid dysfunction and hypogonadism. PubMed database and Google scholar were used to search for the relevant published English language studies and case reports relating to endocrine abnormalities and tuberculosis in Africa up to July 2013. The search terms used were endocrine dysfunction, endocrine abnormalities, adrenal insufficiency, diabetes mellitus, thyroid dysfunction, hypogonadism, disorders of calcium and vitamin D metabolism, tuberculosis, Africa. Reference lists of the identified articles were further used to identify other studies. Adrenal insufficiency, diabetes mellitus and calcium-vitamin D abnormalities were the most prevalent and frequently reported endocrine disorders among adult patients with tuberculosis in Africa. A meticulous endocrine evaluation among tuberculosis patients with suspected endocrine abnormalities should be encouraged in Africa and other high TB endemic regions. Treatment of these endocrine disorders has generally been shown to improve quality of life and reduce mortality.

Citing Articles

Spinal Tuberculosis in a Young Male Patient With Empty Sella Syndrome and Panhypopituitarism.

Choo X, Wong J, Abdul Malik Khiew M, Khoo K, Ramanaidu A, Ramasamy A Cureus. 2025; 17(1):e78223.

PMID: 40027031 PMC: 11871524. DOI: 10.7759/cureus.78223.

Inflammatory and Infectious Disorders in Endocrine Pathology.

Uccella S, Dottermusch M, Erickson L, Warmbier J, Montone K, Saeger W Endocr Pathol. 2023; 34(4):406-436.

PMID: 37209390 PMC: 10199304. DOI: 10.1007/s12022-023-09771-3.

Clinical diagnosis and treatment of primary thyroid tuberculosis: a retrospective study.

Sun L, Dong S, Xu J, Zhu J, Liu J Sao Paulo Med J. 2022; 140(4):547-552.

PMID: 35674611 PMC: 9491481. DOI: 10.1590/1516-3180.2021.0380.R1.29102021.

Male reproductive hormones in patients treated with pretomanid.

Boekelheide K, Olugbosi M, Nedelman J, Everitt D, Smith E, Betteridge M Int J Tuberc Lung Dis. 2022; 26(6):558-565.

PMID: 35650700 PMC: 9165738. DOI: 10.5588/ijtld.21.0654.

Significant barriers to diagnosis and management of adrenal insufficiency in Africa.

Mofokeng T, Beshyah S, Mahomed F, Ndlovu K, Ross I Endocr Connect. 2020; 9(5):445-456.

PMID: 32348958 PMC: 7274557. DOI: 10.1530/EC-20-0129.

References

Nnoaham K, Clarke A . Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol. 2008; 37(1):113-9. DOI: 10.1093/ije/dym247. View

Faurholt-Jepsen D, Range N, PrayGod G, Jeremiah K, Faurholt-Jepsen M, Aabye M . Diabetes is a strong predictor of mortality during tuberculosis treatment: a prospective cohort study among tuberculosis patients from Mwanza, Tanzania. Trop Med Int Health. 2013; 18(7):822-9. DOI: 10.1111/tmi.12120. View

Friis H, Range N, Pedersen M, Molgaard C, Changalucha J, Krarup H . Hypovitaminosis D is common among pulmonary tuberculosis patients in Tanzania but is not explained by the acute phase response. J Nutr. 2008; 138(12):2474-80. DOI: 10.3945/jn.108.094979. View

Banda R, Mhemedi B, Allain T . Prevalence of vitamin D deficiency in adult tuberculosis patients at a central hospital in Malawi. Int J Tuberc Lung Dis. 2011; 15(3):408-10. View

Jeon C, Murray M . Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008; 5(7):e152. PMC: 2459204. DOI: 10.1371/journal.pmed.0050152. View

Gibney K, MacGregor L, Leder K, Torresi J, Marshall C, Ebeling P . Vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Clin Infect Dis. 2008; 46(3):443-6. DOI: 10.1086/525268. View

Harries A, Murray M, Jeon C, Ottmani S, Lonnroth K, Barreto M . Defining the research agenda to reduce the joint burden of disease from diabetes mellitus and tuberculosis. Trop Med Int Health. 2010; 15(6):659-63. PMC: 4465347. DOI: 10.1111/j.1365-3156.2010.02523.x. View

Ross I, Boulle A, Soule S, Levitt N, Pirie F, Karlsson A . Autoimmunity predominates in a large South African cohort with Addison's disease of mainly European descent despite long-standing disease and is associated with HLA DQB*0201. Clin Endocrinol (Oxf). 2010; 73(3):291-8. DOI: 10.1111/j.1365-2265.2010.03807.x. View

Wejse C, Olesen R, Rabna P, Kaestel P, Gustafson P, Aaby P . Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls. Am J Clin Nutr. 2007; 86(5):1376-83. DOI: 10.1093/ajcn/86.5.1376. View

10.

Smith B, Adams L . Nonalcoholic fatty liver disease and diabetes mellitus: pathogenesis and treatment. Nat Rev Endocrinol. 2011; 7(8):456-65. DOI: 10.1038/nrendo.2011.72. View

11.

Arlt W, Allolio B . Adrenal insufficiency. Lancet. 2003; 361(9372):1881-93. DOI: 10.1016/S0140-6736(03)13492-7. View

12.

Hmama Z, Sendide K, Talal A, Garcia R, Dobos K, Reiner N . Quantitative analysis of phagolysosome fusion in intact cells: inhibition by mycobacterial lipoarabinomannan and rescue by an 1alpha,25-dihydroxyvitamin D3-phosphoinositide 3-kinase pathway. J Cell Sci. 2004; 117(Pt 10):2131-40. DOI: 10.1242/jcs.01072. View

13.

Wise G, Marella V . Genitourinary manifestations of tuberculosis. Urol Clin North Am. 2003; 30(1):111-21. DOI: 10.1016/s0094-0143(02)00123-4. View

14.

Ottmani S, Murray M, Jeon C, Baker M, Kapur A, Lonnroth K . Consultation meeting on tuberculosis and diabetes mellitus: meeting summary and recommendations. Int J Tuberc Lung Dis. 2010; 14(12):1513-7. View

15.

Lam K, Lo C . A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol (Oxf). 2001; 54(5):633-9. DOI: 10.1046/j.1365-2265.2001.01266.x. View

16.

Mason A, Lau J, Hoang N, Qian K, Alexander G, Xu L . Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999; 29(2):328-33. DOI: 10.1002/hep.510290235. View

17.

Faurholt-Jepsen D, Range N, PrayGod G, Jeremiah K, Faurholt-Jepsen M, Aabye M . Diabetes is a risk factor for pulmonary tuberculosis: a case-control study from Mwanza, Tanzania. PLoS One. 2011; 6(8):e24215. PMC: 3166171. DOI: 10.1371/journal.pone.0024215. View

18.

Harries A, Billo N, Kapur A . Links between diabetes mellitus and tuberculosis: should we integrate screening and care?. Trans R Soc Trop Med Hyg. 2008; 103(1):1-2. DOI: 10.1016/j.trstmh.2008.08.008. View

19.

Kelestimur F . The endocrinology of adrenal tuberculosis: the effects of tuberculosis on the hypothalamo-pituitary-adrenal axis and adrenocortical function. J Endocrinol Invest. 2004; 27(4):380-6. DOI: 10.1007/BF03351067. View

20.

Cooper M, Stewart P . Corticosteroid insufficiency in acutely ill patients. N Engl J Med. 2003; 348(8):727-34. DOI: 10.1056/NEJMra020529. View