Endocrine Abstracts

Introduction: Adverse events among patients treated for tuberculosis are under-researched and underreported. Two cases of hypothyroidism induced by tuberculosis drug were reported in two older women.

Observations: Case 1: A 69-year-old male, complaining of asthenia and weight gain. He had been treated for his pulmonary tuberculosis during the past 6 months with a quadritherapy antituberculous regimen consisting of Rifampicin, isoniazid, ethambutol, pyrazinamide. A thyroid profile performed when he was admitted to our hospital showed several marked abnormalities: serum thyroid stimulating hormone (TSH) was elevated (40 microIU/ml), free thyroxine level (T4) (7 pmol/l). A thyroid profile, after one month and a half, that was repeated after the exclusion of tuberculosis drug since il is the end of this treatment showed the following results: the TSH level was decreased (6 mIU/ml), the free T4 (12 pmol/l) were normal. During treatment with tuberculosis drug, he had never received thyroid replacement therapy.

Case 2: A 66-year-old female, complaining of asthenia and myalgia. She had been treated for her osteoarticular tuberculosis during the past 12 months with a quadritherapy antituberculous regimen. A thryoid profile performed when she was admitted to our hospital showed several marked abnormalities: elevated serum TSH (60 mIU/ml), and low T4 (5 pmol/l). She received a progressive L-thyoxine therapy. A thyroid profile that was repeated after the exclusion of tuberculosis drug at end of his treatment showed the decrease in needs of L-thyroxine therapy and the following results: the TSH level was normalized (3.1 mIU/ml) without any L-thyroxine replacement.

Discussion: Drug-induced hypothyroidism is an infrequent side effect of tuberculosis therapy, and only a few cases of Rifampicin (RFP) induced hypothyroidism have been reported so far. In this report, we describe patients with hypothyroidism who were receiving therapy for tuberculosis. Rifampicin would be the most incremental in this condition. Early hypothyroidism screening was recommanded in treated tuberculosis to avoid severe and complicated forms especially in the elderly.