title: Adrenocortical insufficiency in smear positive pulmonary tuberculosis.
abstract: We studied 40 patients with pulmonary tuberculosis. All were positive for acid-fast bacilli (AFB) in the sputum. Their mean age was 30 yrs (range 10-50 yrs) and the duration of illness was 26.3 +/- 2.3 months. Radiologically minimal, moderately advanced and far advanced lesions were present in 7 (17.5%), 9 (22.5%) and 23 (57.5%) patients respectively. One patient with endobronchial lesion had no radiological evidence of pulmonary tuberculosis. Clinically, 14 patients (35%) had one or the other features of adrenocortical insufficiency. Postural hypotension was the commonest feature and was present in 11 patients (27.5%), followed by nausea and vomiting (20%), loss of axillary hair and libido (10%), skin and mucosal pigmentation in 7.5% of the cases. ACTH stimulation revealed incomplete adrenocortical insufficiency (partially responsive adrenal) in 5 patients (12.5%) and complete adrenocortical insufficiency (non-responsive adrenal) in 2 patients (5%). Patients with features of adrenal insufficiency had significantly longer duration of illness (p < 0.001) but there was no correlation with extent or type of lesion.
authors.affiliation: Department of Chest and Tuberculosis, Banaras Hindu University, Varanasi.
authors.forename: S C
authors.initials: SC
authors.lastname: Matah
authors.forename: G L
authors.initials: GL
authors.lastname: Kesharwani
authors.forename: G N
authors.initials: GN
authors.lastname: Srivastava
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.forename: J K
authors.initials: JK
authors.lastname: Agrawal
mesh_terms: D000293:Adolescent; D000302:Adrenal Cortex / Q000503:physiopathology*; D000304:Adrenal Cortex Function Tests; D000309:Adrenal Insufficiency / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000503:physiopathology