Assessment of Baseline Biochemical Thyroid Function in Patients with Multi- Drug Resistant Tuberculosis in Maiduguri

Abstract

Background: Most publications on disturbance of thyroid function among patients with drug resistant tuberculosis (DR-TB) have focused mainly on the effects of treatment with second line drugs. Some patients with newly diagnosed DR-TB are likely to have disturbed thyroid function at baseline. These groups of patients need to be actively looked out for in order to institute appropriate therapy to prevent further deterioration.
Methods: This is a prospective review of thyroid function on patients newly diagnosed with Rifampicin-Resistant TB/Multidrug resistant TB (RR-TB/MDR-TB) who underwent baseline thyroid function test (TSH, T3 and T4) at the University of Maiduguri Teaching Hospital (UMTH) between January 2016 and December 2018.
Results: Sixty-two patients were diagnosed with RR-TB, 58% of them were females, with ages ranging between 16 and 70 years. Forty-seven (75.8%) were aged between 20 and 49 years. The baseline results showed that 77.4% were euthyroid, while 16.1% had one form of thyroid disorder or another; Nonthyroidal illnesses (NTIs) were reported in 6.5% of the study population. Of the 16.1% of results that indicated presence of thyroid disorders, 60% were hyperthyroid, 10% had subclinical hyperthyroidism, 20% subclinical hypothyroidism and only 10% were hypothyroid.
Conclusion: Determination of baseline thyroid function in newly diagnosed patients with DR-TB is vital to identify patients with baseline thyroid dysfunction. This will guide proper intervention before commencing second line anti-TB medications that are known to affect thyroid function. Follow-up thyroid function tests, especially among those with hyperthyroidism will show the effect of thionamide therapy and whether they progress to develop any alterations in the reported parameters.